Evaluation of the nephrotoxicity of iodixanol in patients with predisposing factors to contrast medium induced nephropathy referred for contrast enhanced computed tomography

Eur J Radiol. 2007 Jul;63(1):120-3. doi: 10.1016/j.ejrad.2007.01.021. Epub 2007 Feb 21.

Abstract

To determine the risk of developing contrast induced nephropathy (CIN) in intermediate-risk patients receiving iodixanol, an iso-osmolar, dimeric non-ionic contrast agent, for CT in a clinical setting. Hundred consecutive patients referred for a contrast enhanced CT with a serum creatinine concentration>1.1mg/dl and/or a glomerular filtration rate (GFR)<90ml/min were included. Exclusion criteria were a serum creatinine>2.0mg/dl and a GFR<30ml/min or concurrent nephrotoxic agents. Between 60 and 140ml (mean 97+/-42ml) iodixanol (320mgI/ml) were administered at a flow of 2.5-3ml/s. Hydration with 500ml NaCl i.v. was performed before and after contrast injection. Follow-up was completed in 99 patients (age, 64+/-13 years, 68 men). CIN was defined as increase in serum creatinine concentration +0.5mg/dl or >25% above baseline within 72h after contrast administration. Serum creatinine concentration and GFR were 1.40+/-0.22, 1.29+/-0.29, and 1.26+/-0.29mg/dl and 52.2+/-13.9, 51.3+/-21.1, and 51.5+/-15.1ml/min on days 0, 3, and 7, respectively. Three out of 99 (3%) patients who received 90-110ml iodixanol revealed a CIN on day 3 without persistence on day 7. No specific therapy was needed. One out of 99 patients reported an exanthema on days 3 and 7. With the use of iodixanol in intermediate-risk patients, 3% of the patients develop CIN on day 3 without need for a specific therapy or persistence on day 7.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / complications*
  • Contrast Media / administration & dosage
  • Contrast Media / adverse effects
  • Creatinine / blood
  • Diabetes Mellitus, Type 2 / complications
  • Esophageal Neoplasms / complications*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / drug effects
  • Hodgkin Disease / complications*
  • Humans
  • Kidney / drug effects
  • Kidney Diseases / chemically induced*
  • Male
  • Middle Aged
  • Risk Factors
  • Sodium Chloride / administration & dosage
  • Time Factors
  • Tomography, X-Ray Computed / methods*
  • Triiodobenzoic Acids / adverse effects*

Substances

  • Contrast Media
  • Triiodobenzoic Acids
  • Sodium Chloride
  • Creatinine
  • iodixanol