DETERMINATION OF SERUM CREATININE LEVEL BEFORE INTRAVENOUS ADMINISTRATION OF IODINATED CONTRAST-MEDIUM - A SURVEY

RATIONALE AND OBJECTIVES. To study the practice of obtaining serum cre atinine before administering intravenous iodinated contrast medium and the costs associated with this practice. MATERIALS AND METHODS. In Ju ne 1993, a questionnaire was sent to 217 physicians who are members of the Society of Uroradiology or the Society of Computed Body Tomograph y/Magnetic Resonance. There were 149 respondents who completed a total of 70 questionnaires, providing a response rate of 69% (149/217). RES ULTS. The percentage of institutions that always require a serum creat inine before administering intravenous contrast medium for excretory u rography, body computed tomography, and head computed tomography was 1 3%, 20%, and 14%, respectively, In institutions where routine serum cr eatinine is not required, approximately 60% request a serum creatinine in either insulin-dependent or juvenile type 1 diabetes. The mean max imal acceptable time between the serum creatinine value and contrast a dministration is 29 days. It takes a mean of 69 minutes to get the res ults of a stat serum creatinine and costs a mean of 15 dollars for the test, In patients with no risk factors, the mean for the highest seru m creatinine value at which respondents still gave contrast was 2.1 mg /dL; in patients with risk factors, the mean was 1.9 mg/dL. There was no correlation between the use of serum creatinine and the number of s tudies performed in the institution or the type of contrast used. CONC LUSIONS. The practice of requiring a pretest serum creatinine and its interpretation regarding the use of contrast media are quite variable. In view of this disparity in opinion, development and acceptance of a list of patients who are at increased risk for contrast-induced nephr opathy may be desirable.