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).