HIGH-DOSE ADMINISTRATION OF NONIONIC CONTRAST-MEDIA - A RETROSPECTIVEREVIEW

PURPOSE: To assess the safety of high-dose nonionic contrast media (CM ) during a single radiologic procedure. MATERIALS AND METHODS: From No vember 1991 to August 1995, 255 high-dose angiographic procedures were performed in 228 patients with normal serum creatinine (SCr) levels ( less than or equal to 1.6 mg/dL [141 mu mol/L]). All patients received 250-800 mL low-osmolarity CM (300 mg iodine per milliliter). Pre- and postprocedure SCr levels were assessed. Urine output was measured dai ly in the 75 patients who received more than 400 mL CM. With linear re gression analysis, a dose-related elevation in SCr levels was calculat ed. RESULTS: No patient developed abnormal SCr levels (>1.6 mg/dL [141 mu mol/L]) as a result of the CM. Among the patients who received mor e than 400 mt, none developed oliguria over the first 36 hours. With f ollow-up up to 3 years, no patient experienced delayed clinical renal failure. In 11 (43%) patients, the SCr levels increased more than 25%, but all increases were within expected Limits (chi(2) analysis). Line ar regression analysis revealed a 0.015 mg/dL (1 mu mol/L) increase in SCr levels per 100 mL CM. CONCLUSION: Intravenous administration of h igh-dose low-osmolarity iodinated CM appears safe in patients without renal dysfunction or other underlying risk factors, in doses as large as 800 mL (300 mg iodine per milliliter).