If the doctor ordering this exam is not your primary care physician, please be aware your primary care physician may have your recent BUN and Creatinine results.
When physician offices call to schedule an appointment for a patient who requires a BUN and Creatinine test, RMI schedulers will ask the last time the patient had the test performed. Patients undergoing BUN and Creatinine tests at RMI will be asked to arrive 30 minutes before their imaging study to allow time for the blood work.
BUN and Creatinine Guidelines: Which Patients Require Screening?
Iodinated Contrast Guidelines
Blood work (BUN and creatinine) must be obtained for:
- Patients age 60 or older.
- Patients with KNOWN renal insufficiency or borderline kidney failure.
- Patients with only one functioning kidney.
- Patients with a history of elevated Creatinine (1.5 mg/dl or higher).
- If > 2.0 mg/dl, no IV contrast unless on dialysis.
- Patients with lab work older than 60 days.
RMI also offers hydration protocols for patients with slightly elevated BUN and Creatinine (1.7 to 2.0 mg/dl). Please notify RMI scheduler if your patient requires these services.
- General hydration: 1000 cc of normal saline given pre/post IV contrast Sodium Bicarbonate and D5W: add 150 mg of sodium Bicarb to 1 liter (1000 cc) of D5W given pre/post IV contrast.
GFR can be calculated using known body weight, gender, and creatinine.
- GFR <30 ml/min/1.73m2 No contrast (unless signed consent and nephrologist approved)
- GFR 30 – 60 Use Visipaque or Iso-Osmolar (amount injected at discretion of radiologist)
- Hydration protocol may be needed before the CT exam
MRI Contrast Guidelines
Blood work (BUN and creatinine) must be obtained for:
- Patients age 60 or older.
- Patients with KNOWN renal insufficiency or borderline kidney failure.
- Patients with only one functioning kidney.
- Patients with lab work older than 6 months.
Internal Guidelines:
- GFR <30 ml/min/1.73 m2 No contrast (unless signed consent and nephrologist approved) GFR 30 – 60 Dose at radiologist’s discretion GFR >60 Normal (no issues in giving full dose)
- GFR calculated at RMI using body weight, age, gender, and recent creatinine (<6 months old).
Gadolinium:
- If the patient is on dialysis, they have to be dialyzed immediately following the MRI.
