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CT Policy Regarding Contrast-Associated Acute Kidney Injury

For Out-Patients

If the departmental outpatient questionnaire identifies risk for kidney disease, then a Point-of-Care (POC) Creatinine/eGFR test will be performed at the time of the contrast enhanced CT study if no eGFR value within 6 weeks is available. If no risk factors are identified on out-patient screening form, no renal function testing is needed.

For ED and In-Patients

All patients should have eGFR value available within 48 hours of test before receiving IV contrast. If none is available than labs (POC testing is adequate) should be obtained before the contrast enhanced CT is performed.

Renal function testing may be bypassed if medical acuity of patient warrants immediate contrast enhanced CT imaging (example- code stroke CTA, potential acute aortic dissection, Level 1 trauma, etc)

If eGFR value is greater than 30 the patient can receive IV iodinated contrast. If eGFR is less than or equal to 30 the case will need approval by the radiologist before IV contrast is used to minimize risk of contrast related AKI.

Please refer to contrast policy for full details.