Cr Thresholds Table

Cr Thresholds Table 

The following is intended to serve as a guideline for performing diagnostic studies that require contrast medium. Each case is unique and there will be times when the benefit of information gained from contrast administration will supersede the potential risk of reaction or renal toxicity. The following guidelines may not apply in these cases or in life-threatening emergencies.  If contrast media administration is required for a life-threatening diagnosis, then it should not be withheld based on kidney function.

A current creatinine level must be available for all inpatients and for outpatients over 6o years of age prior to administration of intravenous contrast. “Current” is defined as within one month for outpatients and within one week for inpatients.  A same-day Cr is required for all ED patients, with the exception of trauma or extremely STAT exams.  Please also reference a complete list of the recommended indications for measurement of serum creatinine (Who must have a creatinine level prior to IV contrast?)

Patients with an elevated creatinine should receive intravenous contrast only if absolutely necessary. The following table provides a guideline for the use of contrast by type relative to the patients creatinine (mg/dL) or eGFR (%):

UW Guidelines for CT Contrast Selection

Diabetic

Contrast Creatinine eGFR
Iohexol ≤ 1.4 > 50
Iodixanol 1.4 – 1.8 50-40
No Contrast > 1.8 < 40

Non-Diabetic

Contrast Creatinine eGFR
Iohexol < 1.8 > 40
Iodixanol 1.8 – 2.4 40-30
No Contrast > 2.4 < 30