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Iso-Osmolality versus Low-Osmolality Iodinated Contrast Medium at Intravenous Contrast-enhanced CT: Effect on Kidney Function¹

¹ From the Department of Radiology (S.A.N., P.S., J.G.R., P.B.R., K.A.S., P.C., U.J.S.) and Center for Drug and Alcohol Programs (P.K.R.), Medical University of South Carolina, PO Box 250322, 169 Ashley Ave, Charleston, SC 29425. Received August 20, 2007; revision requested October 30; revision received January 3, 2007; accepted February 4; final version accepted February 11. Supported in part by GE Healthcare. Address correspondence to U.J.S. (e-mail: schoepf{at}musc.edu).

Purpose: To determine the effects of iso-osmolality contrast medium compared with a low-osmolality agent on renal function (serum creatinine [SCr] and glomerular filtration rate [GFR]) in high-risk patients undergoing intravenous contrast material–enhanced CT.

Materials and Methods: This HIPAA-compliant study was IRB-approved; formal consent was obtained. One hundred seventeen patients (83 men, 34 women; mean age, 64.3 years; range, 18–86 years) with decreased renal function underwent contrast-enhanced CT with either iso-osmolality iodixanol (n = 61) or low-osmolality iopromide (n = 56). Outcome measures were of SCr increase or GFR decrease for 3 days after CT, a SCr increase (of 0.5 mg/dL [44.2 µmol/L, 25%] or 1.0 mg/dL [88.4 µmol/L, 50%]), a GFR reduction (of 5 mL/min), and patient outcome at 30- and 90-day follow-up.

Results: Iodixanol decreased SCr (mean ± standard deviation) from 1.77 mg/dL ± 0.24 (156.47 µmol/L ± 21.22) at baseline to 1.65 mg/dL ± 0.35 (145.86 µmol/L ± 30.94, P = .046) at day 1, 1.73 mg/dL ± 0.53 (152.93 µmol/L ± 46.85, not significant) at day 2, and 1.73 mg/dL ± 0.55 (152.93 µmol/L ± 48.62, not significant) at day 3 (not significant). Iopromide increased SCr from 1.75 mg/dL ± 0.32 (154.7 µmol/L ± 28.29) at baseline to 1.8 mg/dL ± 0.42 (159.12 µmol/L ± 15.59) at day 1, 1.77 mg/dL ± 0.49 (156.47 µmol/L ± 43.32) at day 2, and 1.77 mg/dL ± 0.62 (156.47 µmol/L ± 54.81) at day 3 (not significant). Iodixanol increased and iopromide decreased GFR on all 3 days after CT (not significant). Fewer patients in the iodixanol group (8.5%) than in the iopromide group (27.8%) had SCr increase 0.5 mg/dL or higher (25%, P = .012). Two patients in each group had SCr increase of 1.0 mg/dL or more (not significant). More patients in the iopromide group (42.3%) than in the iodoxanol group (24.1%) had a GFR reduction of 5 mL/min or higher (P = .0426). No patient had a contrast material–related adverse event at 30- or 90-day follow-up.

Conclusion: Intravenous contrast material application in high-risk patients is unlikely to be associated with permanent adverse outcomes. SCr levels after contrast material administration are lower in iodixanol than iopromide groups.

© RSNA, 2008

This article has been cited by other articles:

				M. D. Cohen, U. J. Schoepf, and P. Costello Is the Use of Intravenous Contrast Material Truly Safe in Patients with Impaired Renal Function? Radiology, May 1, 2009; 251(2): 613 - 615. [Full Text] [PDF]

				C. Pering, P. Lengsfeld, P. Seidensticker, U. J. Schoepf, and P. Costello Iso- versus Low-Osmolar Contrast Media and Contrast Medium-induced Nephropathy Radiology, January 1, 2009; 250(1): 298 - 299. [Full Text] [PDF]