ScreeningA baseline serum creatinin

ScreeningA baseline serum creatinine (with or without eGFR) should be available or obtained before the injection ofcontrast medium in all patients considered at risk for CIN (see below for a list of suggested indications).Choyke et al [68] identified a small list of risk factors that, if screened, would allow a radiologist to identifypatients with impaired renal function with a high degree of specificity; when none of these risk factors waspresent, 94% of such patients had a normal serum creatinine and 99% had a serum creatinine less than 1.7mg/dL. The risk factors screened in this study included: preexisting renal dysfunction, proteinuria, prior kidneysurgery, hypertension, and gout. Patients without these risk factors (especially outpatients [69]) could thereforebe reasonably excluded from serum creatinine screening prior to contrast medium injection resulting insignificant cost savings.There is no agreed-upon acceptable maximum interval between baseline renal function assessment and contrastmedium administration in at-risk patients. Some accept a 30-day interval in outpatients. It seems prudent tohave a shorter interval for inpatients, those with a new risk factor, and those with a heightened risk of renaldysfunction.