Use of high-dose gadolinium as contrast media to avoid radiocontrast media-induced nephropathy.
Patients at risk for radiocontrast media-induced nephropathy (RCIN) with suspected peripheral vascular disease were evaluated with high-dose (0.4 mmol/kg) gadolinium-based (Gd) contrast angiography (AG). The patients who were considered susceptible to RCIN were defined by having one or more of the following: (1) pre-existing serum creatinine (SCr) >124 micromol/l, (2) diabetes mellitus and (3) age >60 years. An increase in SCr > or = 44 micromol/l or > or = 25% of baseline was considered significant. Ten patients underwent peripheral AG using a high dose of Gd without any adverse reaction. The mean age was 67.8 years. Nine (90%) patients were diabetic. The quality of these images was satisfactory for diagnosis in eight out of 10 patients. None of these patients had significant change in SCr. The mean SCr (+/-SD) before, at 48 hours and at 72 hours after AG were 182 +/- 97, 177 +/- 99 and 177 +/- 98 micromol/l, respectively. Based on this limited study, Gd is a promising agent for peripheral angiographic study. In patients at risk for RCIN, the high dose of Gd appears to be safe without obvious nephrotoxicity.
Ruangkanchanasetr
Prajej
P
Division of Nephrology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand. prajej@yahoo.com
Rojanamethin
Suchada
S
Ruamthanthong
Anuchit
A
Chaiprasert
Amnart
A
Supaporn
Thanom
T
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods*; D003287:Contrast Media / Q000009:adverse effects*; D004198:Disease Susceptibility; D005260:Female; D005682:Gadolinium; D006801:Humans; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes; D018570:Risk Assessment
D003287:Contrast Media; D011868:Radioisotopes; D005682:Gadolinium