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Contrast agent nephrotoxicity: comparison of ionic and nonionic contrast agents.
F Stacul1, M Carraro, S Magnaldi
1Istituto di Radiologia, Ospedale di Cattinara, Trieste, Italy.
AJR. American Journal of Roentgenology
|December 1, 1987
Summary
Ionic and nonionic contrast agents showed mild, short-term effects on kidney function in patients undergoing digital subtraction angiography. Ionic monomers are safe for high-dose procedures, offering a cost-effective alternative to nonionic agents.
Area of Science:
- Nephrology
- Radiology
- Pharmacology
Background:
- Ionic contrast agents (e.g., sodium meglumine diatrizoate) and nonionic agents (e.g., iopamidol) are used in imaging procedures.
- Assessing renal function is crucial, especially with high doses of contrast media.
Purpose of the Study:
- To compare the effects of ionic and nonionic contrast agents on glomerular and proximal tubular function.
- To evaluate renal toxicity following high-dose contrast administration for IV digital subtraction angiography.
Main Methods:
- 34 patients with normal renal function received large doses (2.5 ml/kg) of either ionic or nonionic contrast agents.
- Urine samples were collected pre-procedure, immediately after, and on days 1 and 3 post-procedure.
- Analysis included urinary albumin, alanil-aminopeptidase, alpha-glucosidase, and beta-2-microglobulin.
Main Results:
- Both contrast agents induced mild and transient changes in renal function markers.
- These effects were observed despite the administration of high contrast doses.
- No significant long-term renal toxicity was detected by the tested parameters.
Conclusions:
- Ionic monomers can be safely used in high-dose procedures like digital subtraction angiography.
- Ionic contrast agents present a viable, cost-effective alternative to nonionic media for specific applications.
- Renal safety, based on tested biomarkers, is comparable between ionic and nonionic agents at high doses.