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→Other risk factors: Grammar
*Individuals who have undergone kidney transplantation
Metformin use potentially causes lactic acidosis if contrast-induced nephropathy occurs, and European guidelines (ESUR) recommends to stop stopping metformin at least 48 hours before a CT with IV contrast if GFR is between 30 and 44 ml/min/1.73 m<sup>2</sup>, unless emergent, and resume metformin 48 hours after the CT if renal function has not deteriorated. If lower, no contrast should be given unless absolutely necessary.<ref>{{cite web|url=http://www.esur.org/guidelines/|website=ESUR|accessdate=2018-11-09|title=Iodine-based contrast media}}</ref> In such cases, Swedish guidelines only include withholding metformin ''after'' the CT, and not before.<ref>{{cite web|url=file:///C:/Users/mikha19/Downloads/Nationella_rek_metformin_kontrastmedel_v61_2018-05-07.pdf|title=Nationella rekommendationer: Svensk uroradiologisk förenings kontrastmedelsgrupp: METFORMIN. Version 6.1|date=2018-05-07}}</ref>
Other relative or absolute contraindications to IV contrast, regardless of GFR, are [[CT_with_IV_contrast#Allergy|contrast allergy]] and untreated hyperthyroidism.
