DOI: 10.1148/radiol.2402051816
(Radiology 2006;240:614.)
© RSNA, 2006
Dose-related Nephrotoxicity
Mark Rosovsky, MD* and
Henry Rusinek, MD
Advanced Radiology Consultants, 56 Quarry Road, Trumball, CT 06611*
Department of Radiology, NYU Medical Center, New York, NY
e-mail: mark.rosovsky{at}adrad.com
Editor:
Optimization of the timing and dose of contrast media is an important subject that is rapidly evolving, and it was with interest that we read the article by Dr de Monyé and colleagues (1) in the November 2005 issue of Radiology.
The authors state that "the risk of nephrotoxicity is related to the volume of contrast material, and decreasing the volume of contrast material may influence the risk of subsequent nephrotoxicity." The authors cite our previous publication (2) in support of this theory.
Our research involved a retrospective review of 255 high-dose neurointerventional procedures performed in 228 patients with normal baseline creatinine levels. Our cohort of patients received between 250 and 800 mL of iopamidol (Isovue 300; Bracco Diagnostics, Seattle, Wash). (Isovue 300 has a lower concentration of iodine than does the iodixanol administered in the study by Dr de Monyé and colleagues.) Although there was a slight transient dose-related elevation in serum creatinine level, the creatinine level rose only 0.015 mg/dL per 100 mL of contrast material infused. As published in the same article, linear extrapolation suggested that nephrotoxicity would not occur with doses of less than 1500 mL. No patient developed nephrotoxicity within 3 years of the procedures.
There is no evidence from our article to suggest any dose-related nephrotoxicity at doses of 60 or 80 mL.
There may be valid reasons to limit dose of contrast media, but our publication suggests that nephrotoxicity should not be a consideration for diagnostic procedures performed in patients with normal renal function.
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References
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- de Monye C, Cademartiri F, de Weert TT, Siepman DA, Dippel DW, van Der Lugt A. Sixteen–detector row CT angiography of carotid arteries: comparison of different volumes of contrast material with and without a bolus chaser. Radiology 2005;237:555–562.[Abstract/Free Full Text]
- Rosovsky MA, Rusinek H, Berenstein A, Basak S, Setton A, Nelson PK. High-dose administration of nonionic contrast media: a retrospective review. Radiology 1996;200:119–122.[Abstract/Free Full Text]
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