title: Nephrotoxicity of nonionic low-osmolality versus ionic high-osmolality contrast media: a prospective double-blind randomized comparison in human beings.
abstract: 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.
authors.affiliation: Prairie Education Research Cooperative, Springfield, Ill.
authors.forename: R E
authors.initials: RE
authors.lastname: Katholi
authors.forename: G J
authors.initials: GJ
authors.lastname: Taylor
authors.forename: W T
authors.initials: WT
authors.lastname: Woods
authors.forename: K A
authors.initials: KA
authors.lastname: Womack
authors.forename: C R
authors.initials: CR
authors.lastname: Katholi
authors.forename: W P
authors.initials: WP
authors.lastname: McCann
authors.forename: H W
authors.initials: HW
authors.lastname: Moses
authors.forename: J T
authors.initials: JT
authors.lastname: Dove
authors.forename: F L
authors.initials: FL
authors.lastname: Mikell
authors.forename: R C
authors.initials: RC
authors.lastname: Woodruff
mesh_terms: 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
chemical_list: D007477:Ions; D003973:Diatrizoate; D003404:Creatinine; D007479:Iopamidol