Harbor:Creatinine screening prior to IV contrast: Difference between revisions
Ostermayer (talk | contribs) (Text replacement - "Category:Rads" to "Category:Radiology") |
Neil.m.young (talk | contribs) (Text replacement - "* " to "*") |
||
| Line 6: | Line 6: | ||
ED patients do NOT require Cr measurement prior to IV contrast: | ED patients do NOT require Cr measurement prior to IV contrast: | ||
* If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g. trauma patients) | *If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g. trauma patients) | ||
* 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>: | *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>: | ||
** Age >60 | **Age >60 | ||
** History of kidney disease | **History of kidney disease | ||
***Kidney transplant | ***Kidney transplant | ||
***Dialysis | ***Dialysis | ||
| Line 15: | Line 15: | ||
***Renal cancer | ***Renal cancer | ||
***Kidney surgery | ***Kidney surgery | ||
** Family history of kidney failure | **Family history of kidney failure | ||
** Diabetes | **Diabetes | ||
** Hypertension | **Hypertension | ||
** collagen vascular disease (e.g. SLE, scleroderma, rheumatoid arthritis) | **collagen vascular disease (e.g. SLE, scleroderma, rheumatoid arthritis) | ||
** Paraproteinemia (e.g. multiple myeloma) | **Paraproteinemia (e.g. multiple myeloma) | ||
** Recent use of nephrotoxic medication (eg, metformin, aminoglycosides) | **Recent use of nephrotoxic medication (eg, metformin, aminoglycosides) | ||
==See Also== | ==See Also== | ||
Revision as of 11:55, 5 July 2016
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 Cr measurement prior to IV contrast:
- If the study is immediately necessary to prevent life-threatening decompensation or delay in emergent treatment (e.g. trauma patients)
- If they do not meet any of the following criteria[1][2]:
- Age >60
- History of kidney disease
- Kidney transplant
- Dialysis
- Single kidney
- 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)