No increased risk for contrast-induced nephropathy after multiple CT perfusion studies of the brain with a nonionic, dimeric, iso-osmolal contrast medium.
OBJECTIVE
Contrast-induced nephropathy (CIN) is one of the most common causes of in-hospital acute renal failure. The aim of this study was to assess the risk for CIN after repeated administration of the nonionic, dimeric, iso-osmolal contrast agent iodixanol regardless of pre-existing renal function. Changes in serum creatinine (SCr) levels were compared with those of control subjects who did not receive iodinated contrast media (CM).


METHODS
Between January 2005 and March 2007, a total of 100 consecutive patients were prospectively included. Patients underwent a CT perfusion (CTP) study of the brain from clinical signs of acute cerebral infarction. CTP was performed with an intravenous bolus of 60 mL of iodixanol-270. Precontrast and postcontrast SCr levels were obtained, and the CTP study was repeated within 32 hours and postcontrast SCR was assessed. The control group consisted of 100 patients scheduled for plain cranial CT examination, who were not exposed to iodinated CM.


RESULTS
Mean baseline SCr level was 0.96 +/- 0.35 mg/dL in the contrast group and 1.14 +/- 0.74 mg/dL in the control group. After repeated administration of CM, a total of 7 patients had a relative increase of greater than or equal to 25% compared with baseline. In the control group, a relative increase of 25% or more was seen in 12 patients. The difference in the incidence of the rise in SCr of >25% was not significantly different (P = .094).


CONCLUSIONS
Multiple contrast-enhanced studies with intravenously administered iodixanol are not associated with a higher risk for CIN compared with a control group receiving no CM.
Institute for Diagnostic Radiology and Neuroradiology Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany. soenke.langner@uni-greifswald.de
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Langner
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Stumpe
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Kirsch
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Petrik
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Hosten
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D007477:Ions; D007674:Kidney Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008297:Male; D009994:Osmolar Concentration; D010477:Perfusion; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids / Q000009:adverse effects*
D003287:Contrast Media; D007477:Ions; D014283:Triiodobenzoic Acids; C044834:iodixanol