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Creatinine level checked prior to CT scan? Creatinine level checked prior to CT scan?

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  #1  
Unread 03-28-2010, 06:01 PM
Creatinine level checked prior to CT scan?

Hey, ladies!

I was wondering how many of you have had your creatinine level checked prior to having CT scans with contrast? When I called to check my appointment time for my upcoming chest CT (follow-up on 5 mm lung nodule), I was told to report to pre-admit first for labs which turned out to be a creatinine level. I just had a chest CT this January at the same facility, and they didn't check it then. And, I've had scans with contrast in the past where they didn't check, either, but those were all 2005 or earlier. Since my surgery, I've had PET/CT's, and those didn't use the IV contrast.

I did some searches, and it looks like it is a good idea to check creatinine levels, particularly if you're high risk (renal disease, elderly, etc.). If the levels are too high, it's recommended not to use the contrast due to risk of damage to the kidneys. Of course, there have been some cases of renal damage to otherwise"healthy" patients. I didn't even think about the contrast media when weighing the pros/cons for doing the CT scans. I don't have any renal issues that I know of. They did see a "possible small gallstone" in the January scan.

Any ideas? I'm thinking either: 1) they just "oopsed" not checking it last time or 2) the doc ordered it this time since I just had one in January. (Of course, the folks I spoke with when I called weren't sure.) I know I could call the gyn/onc, but I wanted to see what you guys think. I don't want to be overly paranoid, but I don't want to put my kidneys at risk, either. Heck, they're one thing that still works great! The lung nodule we're following first showed on a PET/CT in 11/2007 and hasn't really shown any changes.

Wow! That was long for me! TIA for any info!


monami
  #2  
Unread 03-28-2010, 06:57 PM
Re: Creatinine level checked prior to CT scan?

The reason they check BUN and Creatinine prior to a CT scan is that when they give IV contrast it can be rather hard on the kidneys and CAN put certain people into acute renal failure.
A creatinine below a certain level assures them that your kidneys can take the "contrast"
Could it be that the CT done earlier, was not an IV contrast study?
The thing is that we often do CT scans when a person has kidney disease, but there is a special protocol they can do.
They "pretreat" the kidneys with lots of IV fluids and there is drug that they use to "protect" the kidney.

It is not a cumulative thing, in that the numbers of CTscans with contrast do not add up the damage to your kidneys.
I am not sure if this answers your question?
Janet
It is pretty hard to imagine them "forgetting" to check the creatinine, it is a major part of giving IV contrast and it has been for MANY years.
  #3  
Unread 03-28-2010, 07:04 PM
Re: Creatinine level checked prior to CT scan?

Oh and I should add that the other thing is that they SHOULD Make sure you are not on METFORMIN, which is a drug to treat diabetes and it is also used sometimes in polycystic ovarian disease.
The combo of metformin AND the contrast dye is a real blow to the kidneys, so they are supposed to check to make sure you are not on metformin (glucophage)
At least they should give you special instructions in those situations

Janet
  #4  
Unread 03-28-2010, 09:11 PM
Re: Creatinine level checked prior to CT scan?

Thanks, Janet! Yep, the January CT was indeed with contrast (75cc of Omnipaque-350 at 1.5cc per sec according to the report). I did have to fill out a medical history sheet prior to the test, so they knew I wasn't diabetic, etc. I even had the test at the hospital where I had my PET/CT's (and surgery) so they could easily refer to them if needed.

Guess I'll just make sure I'm plenty hydrated!

  #5  
Unread 03-28-2010, 10:13 PM
Re: Creatinine level checked prior to CT scan?

Good idea. Ditto to all arunner said. They should check the labs like they are doing. Good luck with the scan.
  #6  
Unread 03-28-2010, 11:09 PM
Re: Creatinine level checked prior to CT scan?

Mon Amie
Had you had recent blood work, ie in the previous several weeks??
That is concerning that they did not do any blood work prior to giving you contrast....
In otherwize healthy people they are OK with "recent" bloodwork.
You HAVE made a great point. I guess I thought that it was something that was never missed.
Thanks for pointing it out to everyone to watch for and make sure it is done prior to a CT with IV contrast.

Janet
  #7  
Unread 03-28-2010, 11:23 PM
Re: Creatinine level checked prior to CT scan?

My creatinine (and or creatine ..two different things...) has been checked a few times. Mine is usually very low, which never seems to concern the md, but I guess that is also good news as far as the kidneys go. My only theory was maybe I get leg cramps and such because of this. I think I read that athletes (which I am not) have low levels. Something to do with depleting proteins? (Oh, that's it.... time's up ...don't k now what I am talking about ...Ignore me!) I think I was told to eat organic papaya.
  #8  
Unread 03-29-2010, 02:40 AM
Re: Creatinine level checked prior to CT scan?

I have both checked prior to every scan... then I have to fill out a report of whether or not I have had any adverse reaction to the contrast. I guess the file does not follow you because I have had it done at the same hospital each time.
I feel like this is one of the blunders you hear about. I too can't imagine them asking you to get the bloodwork done. My gyn/onc puts it right on the order for the scan.
  #9  
Unread 03-29-2010, 06:18 AM
Re: Creatinine level checked prior to CT scan?

They didn't start checking my levels until last year when my endo doc put me on Metformin. But since I go for bloodwork every four months, the radiology place just gets a copy of the results from my doctor.
  #10  
Unread 03-29-2010, 05:00 PM
Re: Creatinine level checked prior to CT scan?

  Quote:
Originally Posted by arunner View Post
Mon Amie
Had you had recent blood work, ie in the previous several weeks??
That is concerning that they did not do any blood work prior to giving you contrast....
In otherwize healthy people they are OK with "recent" bloodwork.
You HAVE made a great point. I guess I thought that it was something that was never missed.
Thanks for pointing it out to everyone to watch for and make sure it is done prior to a CT with IV contrast.

Janet
Nope again! I haven't had any blood work since June '09, so there definitely wasn't any to check. At least this can be one of those learning moments so everyone is reminded it needs to be done!

Thanks for the great replies! You guys ROCK!
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