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

Sandstede, Joern J.W.; Roth, Anne; Machann, Wolfram; Kaupert, Christine; Hahn, Dietbert

doi:10.1016/j.ejrad.2007.01.021

« Previous Next »European Journal of Radiology
Volume 63, Issue 1 , Pages 120-123, July 2007

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

Joern J.W. Sandstede
- Department of Radiology, University of Wuerzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg, Germany
- Roentgenzentrum Hamburg, Schaeferkampsallee 5-7, D-20357 Hamburg, Germany
- Corresponding author at: Roentgenzentrum Hamburg, Schaeferkampsallee 5-7, 20357 Hamburg, Germany. Tel.: +49 40 547374700; fax: +49 40 547374770.
Anne Roth
- Department of Radiology, University of Wuerzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg, Germany
Wolfram Machann
- Department of Radiology, University of Wuerzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg, Germany
Christine Kaupert
- Department of Radiology, University of Wuerzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg, Germany
Dietbert Hahn
- Department of Radiology, University of Wuerzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg, Germany

Received 10 October 2006; received in revised form 18 January 2007; accepted 19 January 2007.

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.

Keywords: Contrast agent, Iodixanol, Contrast induced nephropathy, Computed tomography