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Influence of urography on renal function in children. A double blind study with metrizoate and iohexol
1Department of Pediatric Radiology, University Hospital, Oslo, Norway.
Insights
This study compared metrizoate and iohexol in pediatric urography. Metrizoate caused more adverse reactions, but neither contrast medium affected glomerular filtration rate (GFR) or key urinary biomarkers.
Area of Science:
- Pediatric Radiology
- Nephrology
- Pharmacology
Background:
- Urography is essential for diagnosing pediatric urinary tract abnormalities.
- Contrast media selection impacts patient safety and diagnostic accuracy.
- Metrizoate and iohexol are commonly used iodinated contrast agents.
Purpose of the Study:
- To compare the safety and renal effects of metrizoate versus iohexol in pediatric urography.
- To evaluate adverse reactions and changes in glomerular filtration rate (GFR) following contrast administration.
Main Methods:
- A double-blind study involving 32 children undergoing urography.
- Administration of either metrizoate or iohexol.
- Assessment of adverse reactions, urinary alkaline phosphatase, beta 2-microglobulin, albumin, and GFR using 99Tcm-DTPA and X-ray fluorescence techniques.
Main Results:
- All patients receiving metrizoate (15/15) experienced mild to moderate adverse reactions.
- Four patients (4/17) receiving iohexol reported adverse reactions.
- No significant changes in GFR, urinary beta 2-microglobulin, or albumin were observed with either agent.
- Urinary alkaline phosphatase transiently increased 4 hours post-injection for both media.
Conclusions:
- Iohexol appears to be better tolerated than metrizoate in pediatric urography.
- Both contrast media demonstrated no adverse impact on renal function (GFR) in children.
- Further research may explore long-term effects and optimal contrast agent selection for pediatric populations.
Abstract:
Thirty-two children were given either metrizoate or iohexol for urography in a double blind study. Mild to moderate adverse reactions were observed in all patients receiving metrizoate (15/15) and in 4 receiving iohexol (4/17). Alkaline phosphatase in urine was significantly increased 4 hours after the injection of both media, but had returned to pre-injection levels 16 hours later. The excretion of beta 2-microglobulin and albumin was not altered. In 9 children in the metrizoate group and 11 in the iohexol group the glomerular filtration rate (GFR) was determined before urography by the single injection 99Tcm-DTPA-technique and 3 to 4 hours after urography by measuring the plasma disappearance of the contrast medium with the x-ray fluorescence technique. No reduction of GFR was observed.