Contrast Administration in Patients with Elevated Creatinine

Estimated glomerular filtration rate is a better predicator of renal dysfunction than creatinine alone.  The decision to proceed with contrast administration in patients with an estimated GFR < 45 ml/min/1.732 is a matter of clinical judgment, based on the individual circumstances of the patient and following consultation between the radiologist and requesting physician.   Strategies to prevent nephropathy in patients with renal impairment include hydration, reduction of contrast dose, and discontinuation of nephrotoxic drugs. A critical diagnostic study should not be delayed because of excessive concern regarding possible contrast nephropathy.