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Researchers make renal function finding
A study by MUSC
researchers confirms the favorable safety profile of iodixanol, an
isosmolar contrast medium, in patients undergoing computed tomography
(CT) scans who may be at-risk for nephropathy, according to a study
published in the July issue of the journal Radiology.
The use of iodixanol, developed by GE Healthcare, results in lower
incidence of elevated serum creatinine (SCr) or decreased glomerular
filtration rate (GFR) than another contrast medium, iopromide,
according to the MUSC study, which included U. Joseph Schoepf, M.D.,
MUSC professor of radiology and leading CT researcher.
Administering contrast medium in patients with kidney disease must
consider greater implications. Caution must be exercised in patients
with severely impaired renal function, combined renal and hepatic
disease, combined renal and cardiac disease, severe thyrotoxicosis,
myelomatosis, or anuria, particularly when large doses of the contrast
The study by a team of physicians and researchers included 117 patients
with decreased renal function, defined as SCr (greater than) 1.5 mg/mL
or GFR (less than) 60mL/minute. Each patient underwent
contrast-enhanced computed-tomography (CT) studies. Sixty-one patients
were administered iodixanol, while 56 were administered iopromide. The
study measured changes in SCr levels and GFR at plus one, two, and
three days post-CT and then monitored outcomes at 30 and 90 days.
Fewer patients who were administered iodixanol showed an SCr increase
of 25 percent or greater, 8.5 percent versus 28 percent respectively.
No patients in either group showed a contrast media related adverse
event at the 30- or 90-day follow-up. A clinically-relevant GFR
reduction of 5mL/min was found in significantly more patients in the
iopromide group than in the iodixanol group; 42.3 percent versus. 24.1
The study concluded that while intravenous contrast material
application in high-risk patients is unlikely to be associated with
permanent adverse outcomes, SCr levels after contrast material
administration are lower in the iodixanol group than in the iopromide
The authors noted their findings may differ from other recently
published studies on the topic.
“Our systematic serial assessment of SCr level and GFR over three days
after CM (contrast media) administration may have been more sensitive
to detect SCr-level changes compared with the single sampling at a
variable interval (48-72 hours) after contrast medium administration in
the prior investigation,” the authors wrote. “Considering that in most
patients with decreased renal function, the SCr will peak in the first
72 hours after CM administration, multiple measures may provide greater
accuracy regarding SCr dynamics.”
For more information, go to http://md.gehealthcare.com/shared/pdfs/pi/visipaq.pdf.
Friday, Aug. 1, 2008
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