title: Contrast medium-induced acute kidney injury: comparison of intravenous and intraarterial administration of iodinated contrast medium.
abstract: OBJECTIVE
  To compare the incidence of contrast medium-induced acute kidney injury (AKI) after intravenous (IV) administration of iodixanol for computed tomographic (CT) angiography versus intraarterial (IA) injection of iodixanol or low osmolar contrast medium (LOCM) for digital subtraction angiography (DSA) within the same population suspected of peripheral arterial occlusive disease (PAOD).
  
  
  METHODS
  CT angiography was performed with IV iodixanol 320 mgI/mL. After a washout period of 3-14 days, DSA was performed with IA iodixanol or LOCM. Serum creatinine was measured at baseline and 24 hours after administration. Contrast medium-induced AKI was defined by a serum creatinine increase of at least 25% versus baseline at 24 hours. Data were analyzed with χ(2) statistics.
  
  
  RESULTS
  Mean baseline serum creatinine values were comparable between CT angiography with IV contrast medium and DSA with IA contrast medium (93.3 μmol/L ± 52.92 vs 92.8 μmol/L ± 61.70). The incidence of AKI for CT angiography after IV iodixanol administration was 7.6% (20 of 264), which was not statistically different than the 8.7% incidence (22 of 253) for DSA with IA iodixanol or LOCM (P = .641). In the 143 patients who received only iodixanol for both procedures, incidences of contrast medium-induced AKI were comparable after IV (7.0%) and IA (5.6%) administration (P = .626).
  
  
  CONCLUSIONS
  The rates of contrast medium-induced AKI are not statistically different between IV iodixanol for CT angiography and IA iodixanol or another LOCM for DSA in the same population with suspected PAOD.
authors.affiliation: Cardiovascular Research Institute of Southern California, Cedars Sinai Heart Institute, Los Angeles, California, USA. karlsberg@cvmg.com
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Karlsberg
authors.forename: Suhail Y
authors.initials: SY
authors.lastname: Dohad
authors.forename: Rubin
authors.initials: R
authors.lastname: Sheng
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014283:Triiodobenzoic Acids / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D003404:Creatinine; C044834:iodixanol