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Original Research

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

Published Online:Jul 1 2008https://doi.org/10.1148/radiol.2481071484

Abstract

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

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Article History

Published in print: 2008