Iodixanol: risk of subsequent contrast nephropathy in cancer patients with underlying renal insufficiency undergoing diagnostic computed tomography examinations.
OBJECTIVE
To assess the risk of contrast-induced nephropathy in cancer patients with underlying renal insufficiency receiving the iso-osmolar intravenous contrast agent iodixanol for diagnostic computed tomography (CT) examinations.


METHODS
Institutional review board approval was obtained with waiver of informed consent. Our study was a retrospective evaluation comparing the incidence of contrast-induced nephropathy in consecutive patients with underlying renal insufficiency undergoing diagnostic CT examinations receiving iodixanol from November 2003 to June 2005 with a comparison group of patients with normal baseline renal function over the same period. Renal insufficiency was considered a serum creatinine level more than 1.2 mg/dL in females and more than 1.5 mg/dL in males. Contrast nephropathy was considered an absolute elevation of 0.5 mg/dL or 25% elevation in serum creatinine level.


RESULTS
In the group of patients receiving iodixanol with underlying renal insufficiency (189 patients), 9.0% developed contrast nephropathy (P = 0.015) with 4.8% of patients developing irreversible renal damage (P = 0.03). This compared with 4.9% of patients receiving iodixanol (185 patients) and 3.1% of patients receiving iohexol (194 patients) with normal baseline renal function developing contrast nephropathy (P = 0.38) with 3.2% of the iodixanol patients and 1.0% of the iohexol patients developing irreversible renal damage (P = 0.13).


CONCLUSIONS
The risk of contrast-induced nephropathy is significantly higher in patients with underlying renal insufficiency receiving iodixanol than that for patients with normal baseline renal function, but this should not serve as an absolute contraindication for these patients to receive intravenous iodinated contrast for diagnostic CT examinations particularly in patients with life-threatening clinical questions in which contrasted CT may provide valuable information.
Cheruvu
Bharadwaj
B
Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Henning
Kathleen
K
Mulligan
Janine
J
Klippenstein
Donald
D
Lawrence
David
D
Gurtoo
Lalit
L
Gottlieb
Ronald H
RH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007472:Iohexol / Q000009:adverse effects; D007674:Kidney Diseases / Q000139:chemically induced*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids / Q000008:administration & dosage / Q000009:adverse effects*
D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; D003404:Creatinine; C044834:iodixanol