title: Evaluation of the nephrotoxicity of iodixanol in patients with predisposing factors to contrast medium induced nephropathy referred for contrast enhanced computed tomography.
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.
authors.affiliation: Department of Radiology, University of Wuerzburg, Josef-Schneider-Strasse 2, D-97080 Wuerzburg, Germany. sandstede@web.de
authors.forename: Joern J W
authors.initials: JJ
authors.lastname: Sandstede
authors.forename: Anne
authors.initials: A
authors.lastname: Roth
authors.forename: Wolfram
authors.initials: W
authors.lastname: Machann
authors.forename: Christine
authors.initials: C
authors.lastname: Kaupert
authors.forename: Dietbert
authors.initials: D
authors.lastname: Hahn
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000150:complications*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004938:Esophageal Neoplasms / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006689:Hodgkin Disease / Q000150:complications*; D006801:Humans; D007668:Kidney / Q000187:drug effects; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D012965:Sodium Chloride; D003404:Creatinine; C044834:iodixanol