Renal effects of iodixanol in healthy volunteers and patients with severe renal failure.

Contrast medium- (CM) induced nephropathy may be evident from symptoms ranging from acute renal failure to minor changes in tubular function tests. While the incidence is usually low, it increases with the presence of risk factors and when arterial injections are made. The pathogenesis is not fully understood. No specific therapy exists, but in most cases it can be prevented by ensuring that the patient is well hydrated prior to injection of CM. The extended phase 1 study with iodixanol (Visipaque) included detailed investigations on its renal effects. No changes in glomerular filtration rate (GFR) were found. Even though enzymuria was less pronounced after injection of iodixanol than after various monomeric CM, a somewhat higher degree on intrarenal retention of CM was observed on CT examination of the kidneys after iodixanol. In nondiabetic patients suffering from severe renal failure, angiography with either iodixanol or iohexol caused no changes in GFR, or in urinary excretion of protein and enzymes. However, a higher degree of contrast retention than that seen in healthy volunteers was found.