title: Comparison of iodixanol and ioversol for the prevention of contrast-induced nephropathy in diabetic patients after coronary angiography or angioplasty.
abstract: OBJECTIVE
  This study was designed to compare differences in the incidence of contrast-induced nephropathy (CIN) and changes in serum creatinine (SCr) level following iso-osmolar iodixanol or low-osmolar ioversol administration in diabetic patients undergoing coronary angiography, with or without percutaneous coronary intervention (PCI). A number of studies have indicated that iodixanol reduces the risk of CIN in patients with renal impairment, with or without diabetes. Diabetic patients may have some degree of renal dysfunction despite having a normal SCr level.
  
  
  METHODS
  The study included 250 consecutive diabetic patients undergoing coronary angiography with or without PCI. Those enrolled during the first 7 months of the study received ioversol and those enrolled during the following 11 months received iodixanol. The primary study endpoint was the incidence of CIN. Secondary objectives were to identify independent predictors of CIN and to determine the mean increase in SCr 72 hours after contrast injection.
  
  
  RESULTS
  The overall incidence of CIN was 5.6%. The incidence of CIN was significantly lower with iodixanol than with ioversol (2.5% vs. 8.3%, respectively; odds ratio [OR]=0.255; 95% confidence interval [CI], 0.068-0.952; P=.047). A low estimated glomerular filtration rate (60.8+/-29 mL/min per 1.73 m2 in those with CIN vs. 75.3+/-25 mL/min per 1.73 m2 in those without; OR=0.975; 95% CI, 0.952-0.997; P=.03) and ioversol use were independent predictors of CIN.
  
  
  CONCLUSIONS
  In diabetic patients undergoing diagnostic coronary angiography with or without PCI, the iso-osmolar contrast medium iodixanol was associated with a lower incidence of CIN than low-osmolar ioversol.
authors.affiliation: Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario 12 de Octubre, Madrid, España. fhernandez@medynet.com
authors.forename: Felipe
authors.initials: F
authors.lastname: Hernández
authors.forename: Laura
authors.initials: L
authors.lastname: Mora
authors.forename: Julio
authors.initials: J
authors.lastname: García-Tejada
authors.forename: Maite
authors.initials: M
authors.lastname: Velázquez
authors.forename: Iván
authors.initials: I
authors.lastname: Gómez-Blázquez
authors.forename: Teresa
authors.initials: T
authors.lastname: Bastante
authors.forename: Agustín
authors.initials: A
authors.lastname: Albarrán
authors.forename: Javier
authors.initials: J
authors.lastname: Andreu
authors.forename: Juan
authors.initials: J
authors.lastname: Tascón
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003287:Contrast Media; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003404:Creatinine / Q000097:blood; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D003404:Creatinine; C044834:iodixanol; C054871:ioversol