Iodixanol compared to iohexol for contrast procedures: a case-matched retrospective cohort study.
BACKGROUND
Previous studies that have attempted to evaluate the effectiveness of an iso-osmolar contrast medium (IOCM) iodixanol compared to a low-osmolar contrast medium (LOCM) for contrast procedures show variable results.


OBJECTIVE
To evaluate the nephrotoxicity of the IOCM iodixanol compared to the LOCM iohexol.


METHODS
We performed a retrospective cohort study from April 2004 to March 2006. All contrast procedures with a pre- and post-exposure creatinine value were evaluated for inclusion. Contrast nephropathy (CN) was defined as post-exposure creatinine elevation of > or = 25% or > 0.5 mg/dl within 7 days of contrast exposure. Cases of iodixanol exposure were matched to control cases of iohexol exposure (1:1) based on age, sex, presence of diabetes, pre-exposure creatinine value, and type of imaging study performed. We matched 397 cases of iodixanol (IOCM) exposure to 397 cases of iohexol (LOCM) exposure. Cases of iodixanol which could not be matched to controls were not included in the analysis.


RESULTS
After adjustment for prior creatinine, medications, contrast iodine load, prior exposure to contrast material, heart failure, and hypertension, use of iodixanol did not significantly alter rates of CN compared to iohexol (OR 0.92, 95% CI 0.57-1.46; P = 0.71) or mortality (RR 0.79, 95% CI 0.59-1.06; P = 0.12).


CONCLUSIONS
The use of the IOCM iodixanol was not associated with statistically significant protection against contrast nephropathy or all-cause mortality compared to a matched cohort of patients receiving the LOCM iohexol.
From
A M
AM
Division of Cardiology, Department of Radiology, Mayo Clinic, 200 2nd Street SW, Rochester, MN 55905, USA. from.aaron@mayo.edu
Bartholmai
B J
BJ
Williams
A W
AW
McDonald
F S
FS
D000368:Aged; D000792:Angiography; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000009:adverse effects; D003404:Creatinine / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007472:Iohexol / Q000009:adverse effects; D007674:Kidney Diseases / Q000139:chemically induced / Q000628:therapy; D016015:Logistic Models; D008297:Male; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids / Q000009:adverse effects
D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; D003404:Creatinine; C044834:iodixanol