Effect of radio contrast media on residual renal function in peritoneal dialysis patients--a prospective study.
BACKGROUND
Residual renal function is an independent predictor of survival in peritoneal dialysis patients. Systemic administration of radio contrast media (CM) may increase the risk of acute renal failure in patients with impaired renal function not on dialysis. There are few data on the influence of CM administration in dialysis patients.


METHODS
We investigated residual renal function in 10 continuous ambulatory peritoneal dialysis (CAPD) patients who underwent elective diagnostic intravenous or intra-arterial administration of CM (study group). Iopromide (a iodinated, non-ionic hypo-osmolar CM) was used for all interventions. The median dose of CM given was 107.5 ml/patient. Residual renal function (calculated as the average of renal creatinine and renal urea clearance) was measured on the day before the intervention (baseline), on days 1-7, day 10 and day 30 after intervention. Eight CAPD patients without exposure to CM acted as the control group.


RESULTS
There was no significant difference between the two groups in age, gender, diabetes, duration of dialysis and renal clearance at baseline. In the study group, we observed a temporary decline of residual renal clearance after administration of CM (P<0.05; Friedman test). On day 30, clearances were not significantly different from baseline. In the control group, there was no significant change of residual clearance during the observation period. Repeated measures ANOVA revealed no significant difference in the course of residual renal function between study and control groups. The decline of residual renal clearance between baseline and a routine visit after 4 months was comparable between groups.


CONCLUSIONS
Administration of iopromide did not lead to a persistent decline of residual renal function in CAPD patients. Nevertheless, non-ionic hypo-osmolar CM should be given to these patients with the lowest possible dose and only if there is a real clinical indication.
Dittrich
Elisabeth
E
Division of Nephrology and Dialysis, Department of Medicine III, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. elisabeth.dittrich@meduniwien.ac.at
Puttinger
Heidi
H
Schillinger
Martin
M
Lang
Irene
I
Stefenelli
Thomas
T
Hörl
Walter H
WH
Vychytil
Andreas
A
D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D003287:Contrast Media / Q000493:pharmacokinetics*; D003404:Creatinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007472:Iohexol / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000494:pharmacology; D007668:Kidney / Q000187:drug effects; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000379:methods*; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide; D003404:Creatinine