Iso-osmolar radio contrast iodixanol in patients with chronic kidney disease

George M. Tadros, Jamil A. Malik, Connie L. Manske, Bertram L. Kasiske, Stacy E. Dickinson, Charles A. Herzog, Robert F. Wilson, Gladwin Das, Carmelo J. Panetta

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background. Although radio contrast volume has been associated with worsening post-procedural kidney function, this relationship has not been extensively studied using an iso-osmolar contrast agent in chronic kidney disease patients. Methods. We retrospectively studied patients undergoing cardiac catheterization at the University of Minnesota from 2000 to 2004, using the iso-osmolar contrast agent, iodixanol. All patients were included who had calculated creatinine clearance (CCR) < 60 mL/min, not on dialysis, and serum creatinine measured on the same day and within 7 days after the procedure. Comparison of a subgroup with severe chronic kidney disease and diabetes mellitus was compared to a similar historical control group that used the low-osmolar contrast agent, iohexol. Results. Serum creatinine and CCR were 2.9 ± 1.5 mg/dL and 33.4 ± 12.0 mL/min (mean ± standard deviation), respectively, at baseline in 117 cases. Peak creatinine increased by 0.03 ± 0.7 mg/dL after 84.3 ± 67.3 mL of iodixanol was used. Contrast-induced nephropathy definition was fulfilled in 22 (18.8%) cases. A non-significant negative correlation was found between the volume of iodixanol and the change in creatinine (r 2 = 0.0011, p = 0.7254). A subgroup with severe chronic kidney disease and diabetes mellitus with iodixanol had a significantly lower creatinine increase (n = 25, 0.09 ± 0.5 mg/dL), compared to historical controls (n = 42, 0.7 ± 0.8 mg/dL) with iohexol (p < 0.001). A non-significant positive correlation between volume of contrast and change in creatinine was found in this subgroup who received iodixanol (n = 25, r 2 = 0.0756, p = 0.1835), but was significant in the historical controls who received iohexol (n = 42, r 2 = 0.135, p = 0.017). Conclusions. The volume of iso-osmolar radio contrast does not affect the incidence of contrast-induced nephropathy in patients with chronic kidney disease. A randomized trial evaluating the incidence of contrast nephropathy would verify the safety of ad hoc versus staged angiographic procedures in this population.

Original languageEnglish (US)
Pages (from-to)211-215
Number of pages5
JournalJournal of Invasive Cardiology
Volume17
Issue number4
StatePublished - Apr 1 2005

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