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Effect of iodinated contrast media on ionic calcium
K Hayakawa1, Y Okuno, K Fujiwara
1Department of Radiology, Kyoto City Hospital, Kyoto University, Japan.
Acta Radiologica (Stockholm, Sweden : 1987)
|January 1, 1994
Summary
Ionic contrast media (CM) significantly decrease ionized calcium levels in blood and electrolyte solutions. Nonionic CM is recommended for high-risk patients undergoing coronary arteriography to avoid these calcium-binding effects.
Area of Science:
- Radiology
- Biochemistry
- Cardiology
Background:
- Contrast media (CM) are essential for medical imaging.
- Alterations in serum ionized calcium levels can have significant clinical implications.
Purpose of the Study:
- To characterize how contrast media affect serum ionized calcium.
- To identify the mechanisms behind these changes.
- To guide the selection of safer CM for specific patient groups.
Main Methods:
- Human blood and calcium-containing electrolyte solutions were diluted with various CM.
- Ionized calcium levels were measured using an electrometer.
- Tested CM included diatrizoate, iopamidol, iohexol, ioxaglate, saline, Na2-Ca-EDTA, and meglumine.
Main Results:
- Ionic CM (diatrizoate, ioxaglate) caused a greater decrease in ionized calcium than nonionic CM or saline.
- Ioxaglate and diatrizoate demonstrated significant calcium binding, with diatrizoate showing a more prominent effect.
- Na2-Ca-EDTA and meglumine did not reduce ionized calcium levels.
Conclusions:
- The anions in ionic contrast media are responsible for calcium binding.
- Nonionic contrast media are preferable for coronary arteriography in high-risk patients due to minimal impact on ionized calcium.