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).

Article History

Published in print: 1996