CM Safety

Patients at risk for contrast-induced nephropathy

Follow-up of At-Risk Patients

Patients at risk for developing renal impairment should be monitored closely after contrast-enhanced CT examination.

• Discontinue metformin or other biguanide until 48 hours following the procedure; at which time, creatinine should be redrawn. Restart only if and when serum creatinine levels return to normal, or you are certain that the patient is stable.
• Closely monitor urine output, and increase intravenous fluid rate as necessary; input should be greater than output with the goal of maintaining a positive fluid balance and high urine flow rate.
• Consult a nephrologist if patient shows signs of decreased urine output or steady increase in serum creatinine levels.
• Monitor blood urea nitrogen and creatinine levels 24 hours after the procedure. In the case of an increase, the patient should be hospitalized for continued hydration and observation. Serum creatinine levels should be rechecked daily until levels return to baseline.