High-dose administration of nonionic contrast media: a retrospective review.
PURPOSE: To assess the safety of high-dose nonionic contrast media (CM) during a single radiologic procedure. MATERIALS AND METHODS: From November 1991 to August 1995, 255 high-dose angiographic procedures were performed in 228 patients with normal serum creatinine (SCr) levels (< or = 1.6 mg/dL [141 mumol/L]). All patients received 250-800 mL low-osmolarity CM (300 mg iodine per milliliter). Pre- and postprocedure SCr levels were assessed. Urine output was measured daily in the 75 patients who received more than 400 mL CM. With linear regression analysis, a dose-related elevation in SCr levels was calculated. RESULTS: No patient developed abnormal SCr levels (> 1.6 mg/dL [141 mumol/L]) as a result of the CM. Among the patients who received more than 400 mL, none developed oliguria over the first 36 hours. With follow-up up to 3 years, no patient experienced delayed clinical renal failure. In 11 (4.3%) patients, the SCr levels increased more than 25%, but all increases were within expected limits (chi 2 analysis). Linear regression analysis revealed a 0.015 mg/dL (1 mumol/L) increase in SCr levels per 100 mL CM. CONCLUSION: Intravenous administration of high-dose low-osmolarity iodinated CM appears safe in patients without renal dysfunction or other underlying risk factors, in doses as large as 800 mL (300 mg iodine per milliliter).