title: Glomerular filtration rate in evaluation of the effect of iodinated contrast media on renal function.
abstract: OBJECTIVE
  The purpose of this study was to use measured glomerular filtration rate (GFR), the reference standard of renal function, to assess the deleterious effect of iodinated contrast media on renal function. Such an effect has been traditionally defined as a greater than 0.5-mg/dL increase in serum creatinine concentration or a 25% or greater increase 24-72 hours after the injection of iodinated contrast medium.
  
  
  METHODS
  This pilot investigation was focused on the consequences of clinically indicated IV injection of iodinated contrast media; intraarterial injection was excluded. One hundred thirteen patients with normal serum creatinine concentrations were enrolled in an approved protocol. At random, as chosen by one of the investigators, patients underwent imaging with one of three monomeric agents (iopamidol 300, iopromide 300, iohexol 300) and one dimeric agent (iodixanol 320). Measured GFR was determined immediately before CT and approximately 3 and 72 hours after the contrast injection for the CT examination. Iodinated contrast medium, a glomerular filtrate with no tubular excretion or reabsorption, was the GFR marker. Measured GFR was determined by x-ray fluorescence analysis with nonisotopic iodinated contrast media.
  
  
  RESULTS
  Monomeric and dimeric contrast agents in diagnostic CT volumes (based on bodyweight and imaging protocol) did not induce a significant change in measured GFR (95% confidence by Wilcoxon test), suggesting that use of the evaluated contrast media will not lead to more than a 12% variation.
  
  
  CONCLUSIONS
  The three monomeric agents studied and the one dimeric agent were equivalent in terms of lack of a significant effect on measured GFR when administered to patients with a normal GFR.
authors.affiliation: Department of Radiology, New York University Langone Medical Center, 535 E 86th St, New York, NY 10028-7533, USA. Joshua.Becker@nyumc.org
authors.forename: Joshua
authors.initials: J
authors.lastname: Becker
authors.forename: James
authors.initials: J
authors.lastname: Babb
authors.forename: Manuel
authors.initials: M
authors.lastname: Serrano
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D007269:Injections, Intra-Arterial; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives; D007479:Iopamidol / Q000008:administration & dosage; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; C038192:iopromide; D003404:Creatinine; C044834:iodixanol; D007479:Iopamidol