Harbor:Creatinine screening prior to IV contrast

Background

To expedite the appropriate use of creatinine screening in ED patients requiring IV contrast for CT or other radiographic evaluation

Guideline

1. ED patients undergoing evaluation for emergent conditions do NOT require Cr measurement prior to IV contrast if they are <60 years old AND do NOT have:
   1. history of kidney failure or transplant,
   2. family history of kidney failure,
   3. diabetes, hypertension,
   4. collagen vascular disease (eg, SLE, scleroderma, rheumatoid arthritis),
   5. paraproteinemia syndrome (eg, myeloma), or
   6. recent use of nephrotoxic medication (eg, aminoglycosides) as determined by the attending emergency physician.
2. Emergency department patients do not require a creatinine level to be checked prior to the administration onv contrast if the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment as determined by the attending emergency physician.

Source

• American College of Radiology Manual on Contrast Administration
• Harbor-UCLA Medical Center Policy, "Emergency Department Creatinine Screening Guidelines for Radiographic Evaluations"