Nephrotoxicity of nonionic low-osmolality versus ionic high-osmolality contrast media: a prospective double-blind randomized comparison in human beings.
To test whether a nonionic, low-osmolality contrast medium (iopamidol) administered for coronary angiography was less harmful to renal function than ionic, high-osmolality medium (sodium diatrizoate), a prospective, double-blind randomized study of 70 patients with normal or mildly depressed renal function (serum creatinine < or = 2.0 mg/dL (175 mumol/L) was performed. Creatinine clearance was determined before coronary angiography and 24 and 48 hours after. There were no significant differences between the low- and high-osmolality groups with regard to age, baseline creatinine clearance, or dose of contrast medium given. In patients receiving low-osmolality medium (n = 35), creatinine clearance decreased by 19% +/- 13 (1 standard deviation) at 24 hours and recovered by 48 hours. In patients receiving high-osmolality medium (n = 35), creatinine clearance decreased by 40% +/- 16 at 24 hours and remained depressed by 47% +/- 14 at 48 hours. In patients with normal or mildly depressed renal function, use of a non-ionic, low-osmolality contrast medium minimized nephrotoxicity as measured by reductions in creatinine clearance after coronary angiography.
Katholi
R E
RE
Prairie Education Research Cooperative, Springfield, Ill.
Taylor
G J
GJ
Woods
W T
WT
Womack
K A
KA
Katholi
C R
CR
McCann
W P
WP
Moses
H W
HW
Dove
J T
JT
Mikell
F L
FL
Woodruff
R C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003404:Creatinine / Q000097:blood; D003973:Diatrizoate / Q000009:adverse effects*; D004311:Double-Blind Method; D006801:Humans; D007477:Ions; D007479:Iopamidol / Q000009:adverse effects*; D007668:Kidney / Q000187:drug effects*; D008875:Middle Aged; D009994:Osmolar Concentration; D011446:Prospective Studies
D007477:Ions; D003973:Diatrizoate; D003404:Creatinine; D007479:Iopamidol