•  

    Pre-Exam Lab Services

    Some imaging procedures require that lab results be completed prior to the appointment, to ensure that the patient can safely receive contrast material. To help your staff and patients understand the importance of bringing lab results to imaging appointments, we have provided a link below to guidelines on pre-contrast BUN & Creatinine testing requirements.

    To help streamline the process for patients and their physicians, RMI provides this lab test at our facilities in Grand Blanc, Fenton, Lennon Road (Flint), Novi, Royal, and Southgate.

    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.