ANGIOGRAPHY WITH NONIONIC X-RAY CONTRAST-MEDIA IN SEVERE CHRONIC-RENAL-FAILURE - RENAL-FUNCTION AND CONTRAST RETENTION

The effects of contrast media on renal function and the cortical reten tion of contrast media after abdominal angiography were investigated. Sixteen nondiabetic patients with predialytic chronic renal failure re ceived either the nonionic dimeric contrast medium iodixanol or the mo nomeric contrast medium iohexol in a double-blind randomized study. Al l patients were well hydrated before, during and after angiography. Me an Tc-99m-DTPA clearance was 14.0 ml/min/1.73 m(2) in the iodixanol gr oup, and 9.3 ml/min/1.73 m(2) in the iohexol group at baseline. No sta tistically significant changes were seen after angiography. Serum crea tinine increased significantly 48 and 72 h after angiography in both g roups, and then normalized. Creatinine clearance was reduced only in t he iohexol group, at 72-96 h. The urinary excretion of renal enzymes a nd of total protein did not change significantly. No patients develope d oliguria or required dialysis during the 7-day observation period. I ncreased attenuation in the renal cortex, measured by computed tomogra phy and probably reflecting intracellular retention of contrast medium , peaked at 24 h, and was observed in both groups during the follow-up period. Thus, although transient and minor changes in glomerular filt ration rate were noted, both iodixanol and iohexol were safe for use i n angiography in nondiabetic patients with severe chronic failure when the patients were well hydrated.