Acute renal failure associated with ioxaglate, a low-osmolality radiocontrast agent

Iodinated radiocontrast agents may cause acute renal failure, particularly in patients with preexisting renal failure, heart failure, or diabetes. The low-osmolality contrast agents cause less hypersensitivity, but substantial nephrotoxicity has not been noted. We report three high-risk patients who developed acute renal failure after one of these new agents, ioxaglate, was administered for coronary arteriography and ventriculography. The renal failure was severe: two of the patients required dialysis. We could find no previously reported cases of acute renal failure associated with ioxaglate. Despite their theoretical advantages, the low-osmolality contrast agents may cause acute renal failure in patients who are at risk and should be used with the same precautions as the conventional agents.