Iopromide dosage and urographic image quality: is there an optimal dose?

The influence of increasing doses of contrast medium (CM; 0.75, 1.0, 1.5, and 2.0 ml iopromide/kg body weight; 300 mg I/ml) was examined in a randomized, double-blind study. An increase of the dosage resulted in a statistically significant improvement of the quality of the radiographic visualization. This was most pronounced with an increase from 0.75 to 1.0 ml/kg body weight and least pronounced with the increase from 1.5 to 2.0 ml/kg body weight. This improvement was not only visible in the overall quality, but in each part of the urinary tract, the calyces, the pelves, the ureters, and most especially at the parenchyma. Due to economic considerations at the present, a dose of 1.0 ml/kg (300 mg I/ml) is viewed as adequate. Doses below this level should be avoided due to the poorer image quality that results. From a purely medical point of view, the injection of 1.5 ml of nonionic CM/kg body weight is considered optimal.