Elimination of the nonionic contrast medium iopromide in end-stage renal failure by hemodialysis

The increasing life-expectancy of patients with end-stage renal failure has led to a significant increase of diagnostic and interventional radiologic measures. The contrast media used in these procedures, however, are excreted only very slowly, due to the renal failure. We have therefore studied the elimination of the nonionic x-ray contrast medium iopromide (Ultravist) during dialysis in nine anuric patients with end-stage renal failure. All of the patients received 100 ml iopromide (30 g iodine) for the visualization of their Cimino-Brescia shunt. They were then dialyzed 30 minutes after the injection. The plasma iodine concentration declined from 1.7 to 0.7 mg I/ml plasma during the 3-hour dialysis treatment. The iopromide clearance was a constant 80 ml/min. This is the equivalent of a relative dialysance of 65% of the creatinine clearance. There were no incidences of side effects requiring therapy in this high-risk group of patients. The quality of the image was good in all cases. Iopromide proved itself to be an x-ray contrast medium with a low rate of side effects, which can be effectively eliminated from the body by means of conventional dialysis.