Iodixanol compared to iohexol for contrast procedures: a case-matched retrospective cohort study

Area of Science:

• Nephrology
• Radiology
• Cardiology

Background:

• Previous studies on iodixanol (IOCM) versus low-osmolar contrast media (LOCM) show mixed results regarding effectiveness.
• Evaluating contrast media nephrotoxicity is crucial for patient safety in radiological procedures.

Purpose of the Study:

• To compare the nephrotoxicity of iodixanol (IOCM) against iohexol (LOCM).
• To assess the impact of different contrast media on contrast nephropathy (CN) and mortality rates.

Main Methods:

• A retrospective cohort study matched 397 iodixanol exposures with 397 iohexol exposures (1:1).
• Inclusion criteria required pre- and post-exposure creatinine values within 7 days of contrast exposure.
• Contrast nephropathy (CN) defined as creatinine elevation ≥25% or ≥0.5 mg/dl.

Main Results:

• Iodixanol use did not significantly alter contrast nephropathy rates compared to iohexol (OR 0.92, P=0.71).
• No significant difference in all-cause mortality was observed between iodixanol and iohexol groups (RR 0.79, P=0.12).
• Adjustments were made for creatinine, medications, contrast load, prior exposure, heart failure, and hypertension.

Conclusions:

• Iso-osmolar contrast medium iodixanol offers no statistically significant protection against contrast nephropathy compared to low-osmolar contrast medium iohexol.
• Iodixanol was not associated with reduced all-cause mortality when compared to iohexol in this matched cohort.