reference: Manual on Contrast Media Version 9.0, ACR
All inpatients require a current (within one week) creatinine level or estimated glomerular filtration rate (eGFR) prior to an IV contrast-enhanced CT.
Outpatients being scheduled for a CT with IV contrast will not require a serum creatinine unless they meet one of the following criteria:
- Over 60 years old.
- Diabetic treated with insulin or other provider-prescribed medications (e.g., metformin).
- Receiving chemotherapy or an aminoglycoside within the last 1 month.
- Diagnosis of a collagen vascular disease.
- Diagnosis of a paraproteinemia syndrome or disease (e.g., multiple myeloma).
- History of “chronic kidney disease” including tumor, surgery, single kidney, or kidney transplantation.
- History of end-stage liver disease.
- History of severe congestive heart failure.
For outpatients, a measure of renal function is considered current if it has been obtained within one month.
These parameters are intended to serve as guidelines. Obviously, medical necessity may mandate administering contrast without a current measure of renal function.