Use GFR practice

Do we use serum creatinine levels or GFR in practice for establishing risk prior to CT Scanning ?


As in tradition we use creatinine level but now we use long term move to GFR . GFR tends to be more accurate in older patient . Both we can used in clinical practice .
The latest recommendation from ACR .

Who should get baseline serum creatinine level before CT scanning  ? 

•   Age > 60 
• History of renal disease , including 
• Dialysis
• Kidney transplant 
• Single kidney
• Renal cancer
• Renal surgery
• History of Hypertension requiring medical therapy
• History of Diabetes mellitus 
• Metformin or metformin - containing drug conbination.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              The major preventive action against CIN is to ensure adequate hydration . The ideal infusion rate and volume is unknown .But isotonic fluids are prefered ( Lactate Ringer OS or 0.9% normal saline ). One possible protocol would be 0.9% saline at 100ml/hr,beginning 6 to 12 hour before and continuing 4 to 12 hour after intravascular  iodinate contrast medium administration .