Are Screening Creatinine Levels Necessary Prior to Outpatient CT Examinations?
Tippins RB, et al Radiology 2000;216:481 This retrospective analysis of the records of 2,034 outpatients evaluated whose serum creatinine was measured prior to IV contrast enhanced CT scanning. The creatinine was normal (less than 1.4 mg/dL) in 92 percent of patients. The creatinine was considered borderline (1.5 to 1.9 mg/dL) in five percent and abnormal (greater than 2 mg/dL) in only three percent. The baseline creatinine was not related to age. Almost every patient with an abnormal serum creatinine had one or more risk factors for nephrotoxicity that had been previously identified. The most common was prior renal insufficiency. The rest of the patients had diabetes. In only two of 2,034 patients did these authors find a creatinine that was in the abnormal range (one was 2.0 and the other 2.2 mg/dL) without identifiable historical risk factors. The authors conclude that questioning patients prior to IV contrast administration for the presence of prior renal disease or diabetes would
