Harbor:Creatinine screening prior to IV contrast: Difference between revisions

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==Background==
==Background==
To expedite the appropriate use of creatinine screening in ED patients requiring IV contrast for CT or other radiographic evaluation
*It may be possible to reduce the use of creatinine screening in ED patients requiring IV contrast for CT or other radiographic evaluation
*Data is sparse, however, and any guidelines should be utilized with that in mind, and in the context of local policies.


==Guideline==
==Guideline==
ED patients do NOT require Cr measurement prior to IV contrast if:
ED patients do NOT require creatinine measurement prior to IV contrast:


#  They are '''<60 years old''' AND do NOT have
*If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g. trauma patients)
## history of kidney failure or transplant
*If they do not meet any of the following criteria<ref>Tippins RB, Torres WE, Baumgartner BR, Baumgarten DA. Are screening serum creatinine levels necessary prior to outpatient CT examinations? Radiology. 2000 Aug;216(2):481-4.</ref><ref>ACR Manual on Contrast Media – Version 10, 2015. [http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Contrast%20Manual/2015_Contrast_Media.pdf PDF] Accessed 08/10/15</ref>:
## family history of kidney failure
**Age >60
## diabetes, hypertension
**History of kidney disease
## collagen vascular disease (eg, SLE, scleroderma, rheumatoid arthritis)
***[[Kidney transplant]]
## paraproteinemia syndrome (eg, myeloma)
***[[Dialysis]]
## recent use of nephrotoxic medication (eg, aminoglycosides)
***Single kidney
#If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment
***Renal cancer
***Kidney surgery
**Family history of kidney failure
**[[Diabetes]]
**Hypertension
**[[Collagen vascular disease]] (e.g. [[SLE]], [[scleroderma]], [[rheumatoid arthritis]])
**Paraproteinemia (e.g. [[multiple myeloma]])
**Recent use of nephrotoxic medication (eg, [[metformin]], [[aminoglycosides]])


==See Also==
==See Also==
*[[Contrast-induced nephropathy]]


==References==
<References/>


==Source==
[[Category:Radiology]]
*American College of Radiology Manual on Contrast Administration
[[Category:Renal]]
*Harbor-UCLA Medical Center Policy, "Emergency Department Creatinine Screening Guidelines for Radiographic Evaluations"
 
[[Category:Rads]]
[[Category:Nephro]]
[[Category:GU]]

Revision as of 14:49, 14 October 2019

Background

  • It may be possible to reduce the use of creatinine screening in ED patients requiring IV contrast for CT or other radiographic evaluation
  • Data is sparse, however, and any guidelines should be utilized with that in mind, and in the context of local policies.

Guideline

ED patients do NOT require creatinine measurement prior to IV contrast:

See Also

References

  1. Tippins RB, Torres WE, Baumgartner BR, Baumgarten DA. Are screening serum creatinine levels necessary prior to outpatient CT examinations? Radiology. 2000 Aug;216(2):481-4.
  2. ACR Manual on Contrast Media – Version 10, 2015. PDF Accessed 08/10/15