Abstract
Three hundred seven high risk patients with renal impairment (serum creatinine ≥ 1.5 mg/dl) were randomized in a double-blind manner to either iopamidol (a nonionic, low osmolar radiocontrast agent) or diatrizoate (a conventional radiocontrast agent) at cardiac angiography with subsequent follow-up study of renal function. Baseline clinical and angiographic variables were similar in the iopamidol (n = 155) and diatrizoate (n = 152) groups. Change in renal function after angiography was less pronounced with iopamidol compared with diatrizoate as measured by mean (± SD) increase in 24 h serum creatinine (0.11 ± 0.2 versus 0.22 ± 0.26 mg/dl, p < 0.001), mean maximal increase in serum creatinine (0.2 ± 0.44 versus 0.38 ± 0.73 mg/dl, p < 0.0001) and percent of patients with a maximal increase in serum creatinine > 0.5 mg/dl (8% versus 19%, p < 0.01). Such differences could not be documented in diabetic patients using insulin. There was no significant difference between agents in the number of patients developing clinically severe acute renal dysfunction. It is concluded that iopamidol is less nephrotoxic than diatrizoate in high risk patients at cardiac angiography. However, the difference in nephrotoxicity is small, of no major clinical significance in the majority of high risk patients and could not be documented in insulin-using diabetic patients. Iopamidol may be the preferred agent in certain patients with advanced renal impairment, but further study is warranted.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 384-390 |
| Number of pages | 7 |
| Journal | Journal of the American College of Cardiology |
| Volume | 17 |
| Issue number | 2 |
| State | Published - 1991 |
| Externally published | Yes |
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Cite this
A randomized comparison of the nephrotoxicity of iopamidol and diatrizoate in high risk patients undergoing cardiac angiography. / Taliercio, C. P.; Vlietstra, R. E.; Ilstrup, D. M.; Burnett, John C Jr.; Menke, K. K.; Stensrud, S. L.; Holmes, David.
In: Journal of the American College of Cardiology, Vol. 17, No. 2, 1991, p. 384-390.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A randomized comparison of the nephrotoxicity of iopamidol and diatrizoate in high risk patients undergoing cardiac angiography
AU - Taliercio, C. P.
AU - Vlietstra, R. E.
AU - Ilstrup, D. M.
AU - Burnett, John C Jr.
AU - Menke, K. K.
AU - Stensrud, S. L.
AU - Holmes, David
PY - 1991
Y1 - 1991
N2 - Three hundred seven high risk patients with renal impairment (serum creatinine ≥ 1.5 mg/dl) were randomized in a double-blind manner to either iopamidol (a nonionic, low osmolar radiocontrast agent) or diatrizoate (a conventional radiocontrast agent) at cardiac angiography with subsequent follow-up study of renal function. Baseline clinical and angiographic variables were similar in the iopamidol (n = 155) and diatrizoate (n = 152) groups. Change in renal function after angiography was less pronounced with iopamidol compared with diatrizoate as measured by mean (± SD) increase in 24 h serum creatinine (0.11 ± 0.2 versus 0.22 ± 0.26 mg/dl, p < 0.001), mean maximal increase in serum creatinine (0.2 ± 0.44 versus 0.38 ± 0.73 mg/dl, p < 0.0001) and percent of patients with a maximal increase in serum creatinine > 0.5 mg/dl (8% versus 19%, p < 0.01). Such differences could not be documented in diabetic patients using insulin. There was no significant difference between agents in the number of patients developing clinically severe acute renal dysfunction. It is concluded that iopamidol is less nephrotoxic than diatrizoate in high risk patients at cardiac angiography. However, the difference in nephrotoxicity is small, of no major clinical significance in the majority of high risk patients and could not be documented in insulin-using diabetic patients. Iopamidol may be the preferred agent in certain patients with advanced renal impairment, but further study is warranted.
AB - Three hundred seven high risk patients with renal impairment (serum creatinine ≥ 1.5 mg/dl) were randomized in a double-blind manner to either iopamidol (a nonionic, low osmolar radiocontrast agent) or diatrizoate (a conventional radiocontrast agent) at cardiac angiography with subsequent follow-up study of renal function. Baseline clinical and angiographic variables were similar in the iopamidol (n = 155) and diatrizoate (n = 152) groups. Change in renal function after angiography was less pronounced with iopamidol compared with diatrizoate as measured by mean (± SD) increase in 24 h serum creatinine (0.11 ± 0.2 versus 0.22 ± 0.26 mg/dl, p < 0.001), mean maximal increase in serum creatinine (0.2 ± 0.44 versus 0.38 ± 0.73 mg/dl, p < 0.0001) and percent of patients with a maximal increase in serum creatinine > 0.5 mg/dl (8% versus 19%, p < 0.01). Such differences could not be documented in diabetic patients using insulin. There was no significant difference between agents in the number of patients developing clinically severe acute renal dysfunction. It is concluded that iopamidol is less nephrotoxic than diatrizoate in high risk patients at cardiac angiography. However, the difference in nephrotoxicity is small, of no major clinical significance in the majority of high risk patients and could not be documented in insulin-using diabetic patients. Iopamidol may be the preferred agent in certain patients with advanced renal impairment, but further study is warranted.
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UR - http://www.scopus.com/inward/citedby.url?scp=0025884525&partnerID=8YFLogxK
M3 - Article
C2 - 1991894
AN - SCOPUS:0025884525
VL - 17
SP - 384
EP - 390
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 2
ER -