Literature DB >> 21470810

Persistent renal enhancement after intra-arterial versus intravenous iodixanol administration.

Shinn-Huey Chou1, Zhen J Wang, Jonathan Kuo, Miguel Cabarrus, Yanjun Fu, Rizwan Aslam, Judy Yee, Jeffrey M Zimmet, Kendrick Shunk, Brett Elicker, Benjamin M Yeh.   

Abstract

PURPOSE: To examine the clinical significance of persistent renal enhancement after iodixanol administration.
METHODS: We retrospectively studied 166 consecutive patients who underwent non-enhanced abdominopelvic CT within 7 days after receiving intra-arterial (n=99) or intravenous (n=67) iodixanol. Renal attenuation was measured for each non-enhanced CT scan. Persistent renal enhancement was defined as CT attenuation>55 Hounsfield units (HU). Contrast-induced nephropathy (CIN) was defined as a rise in serum creatinine>0.5 mg/dL within 5 days after contrast administration.
RESULTS: While the intensity and frequency of persistent renal enhancement was higher after intra-arterial (mean CT attenuation of 73.7 HU, seen in 54 of 99 patients, or 55%) than intravenous contrast material administration (51.8 HU, seen in 21 of 67, or 31%, p<0.005), a multivariate regression model showed that the independent predictors of persistent renal enhancement were a shorter time interval until the subsequent non-enhanced CT (p<0.001); higher contrast dose (p<0.001); higher baseline serum creatinine (p<0.01); and older age (p<0.05). The route of contrast administration was not a predictor of persistent renal enhancement in this model. Contrast-induced nephropathy was noted in 9 patients who received intra-arterial (9%) versus 3 who received intravenous iodixanol (4%), and was more common in patients with persistent renal enhancement (p<0.01).
CONCLUSION: Persistent renal enhancement at follow-up non-contrast CT suggests a greater risk for contrast-induced nephropathy, but the increased frequency of striking renal enhancement in patients who received intra-arterial rather than intravenous contrast material also reflects the larger doses of contrast and shorter time to subsequent follow-up CT scanning for such patients.
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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Year:  2011        PMID: 21470810      PMCID: PMC3160516          DOI: 10.1016/j.ejrad.2011.02.044

Source DB:  PubMed          Journal:  Eur J Radiol        ISSN: 0720-048X            Impact factor:   3.528


  23 in total

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4.  Human pharmacokinetics of iodixanol.

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10.  Renal effects of iodixanol in experimental animals.

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2.  Guidelines on the use of iodinated contrast media in patients with kidney disease 2012: digest version. JSN, JRS, and JCS Joint Working Group.

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7.  Effect of Repeated Injection of Iodixanol on Renal Function in Healthy Wistar Rats Using Functional MRI.

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