Contrast-induced nephropathy-choice of contrast agents to reduce renal risk.
Contrast-induced nephropathy (CIN) represents an increasing healthcare burden and challenge as the frequency of diagnostic imaging and interventional procedures increases, particularly among patients at risk for developing CIN. Universally accepted strategies to reduce the risk for CIN include careful patient screening and selection, adequate patient hydration, limiting the volume of contrast medium administered, and choosing a safe, non-ionic, low-osmolar contrast agent. For both intra-arterial and intravenous use, all ionic and non-ionic iodinated contrast agents may further impair renal function in high-risk patients. Based on comparisons of contrast media in proximal renal tubular cell culture and in recent robust head-to-head prospective clinical trials in high-risk patients, however, iso-osmolar iodixanol and low-osmolar iopamidol are comparable and appear to be the contrast agents of choice to reduce renal risk for CIN.
Katholi
Richard E
RE
Southern Illinois University School of Medicine and Prairie Cardiovascular Consultants, Ltd, Springfield, IL, USA. rkatholi@prairieheart.com
D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry; D007674:Kidney Diseases / Q000139:chemically induced*; D007677:Kidney Function Tests; D009994:Osmolar Concentration; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D014283:Triiodobenzoic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol; D007479:Iopamidol