Giving contrast is always a risk-benefit analysis. If the contrast will probably give you important or desirable information when no other test is available, and you will act on that result - then I use it. In this situation I give the least amount of contrast possible for a radiographically relevant result. That being said, oral or rectal contrast has an incredibly low systemic absorption rate of 2-3% making CIN a very small risk in even somebody with pre-existing renal impairment. In your clinical situation the greatest risk is aspiration pneumonitis. Remember the only consistently proven ways of reducing CIN is good hydration and ceasing other nephrotoxins. So yes, provided the patient can protect their airway (patient has to lie flat for a CT), I would give it in discussion with the radiologist