A 65-year-old taking metformin has stable eGFR 38 mL/min/1.73 m² and no acute kidney injury. He requires routine IV iodinated contrast CT, not an

Question

A 65-year-old taking metformin has stable eGFR 38 mL/min/1.73 m² and no acute kidney injury. He requires routine IV iodinated contrast CT, not an intra-arterial first-pass renal exposure. Which metformin plan is appropriate under the RANZCR guideline?

Accepted Answer

Continue metformin through the IV contrast study and monitor kidney function if the clinical course changes

Answer

Change metformin to basal insulin before contrast and resume metformin after 48 hours of stable kidney function

Answer

Continue metformin through contrast, then withhold it for 48 hours if post-procedure creatinine rises

Answer

Withhold metformin on contrast day and restart after 48 hours if repeat kidney function remains stable

Answer

Withhold metformin 48 hours before contrast and restart 48 hours afterwards if kidney function remains stable

Metformin and Contrast — RACP Adult Medicine MCQ

A 65-year-old taking metformin has stable eGFR 38 mL/min/1.73 m² and no acute kidney injury. He requires routine IV iodinated contrast CT, not an intra-arterial first-pass renal exposure. Which metformin plan is appropriate under the RANZCR guideline?