It is well recognized that serum creatinine concentration by itself is a poor surrogate for renal function and that estimated glomerular filtration rate (GFR) should be calculated for each patient.4 Renal function (as estimated by calculated GFR) is important for dosing medi- cations (including anticoagulants) and contrast media. An excess of bleeding events has been reported in patients who do not receive appropriately adjusted dosing of anticoagula- tion in the setting of renal dysfunction.31,32 Furthermore, cur- rent guidelines recommend use of preprocedural hydration in patients who have a reduced GFR.33,34 Estimated GFR should be calculated as close to the day of the procedure as possible and should be documented in the medical record, ideally as part of the preprocedural checklist. The writing committee also recommends that the total amount of contrast volume administered to a patient should be documented clearly in the procedure report. The risk of con- trast-induced renal injury increases with increasing volume of contrast administered, and physicians should follow a princi- pal of as low as reasonably possible, especially in patients who have preexisting renal dysfunction.35 Although recent studies suggested an association between high total contrast dose (or GFR-based contrast dose) and contrast-induced acute kidney injury, we do not believe that the current evidence is robust enough to support a specific contrast threshold that should not be exceeded under any circumstance.4,32 In addi- tion, no evidence indicates that simply documenting the dose is linked to improved patient outcomes. For these reasons, the writing committee designated this measure only for internal quality improvement at the present time. Of course, individual circumstances during a case often will dictate whether the use of additional contrast is worthwhile for the safety of the pro- cedure. 