Mr. Prince et al., NEPHROTOXICITY OF HIGH-DOSE GADOLINIUM COMPARED WITH IODINATED CONTRAST, Journal of magnetic resonance imaging, 6(1), 1996, pp. 162-166
To determine if high-dose gadolinium chelates are less nephrotoxic tha
n iodinated contrast. Records of 342 patients who had received high-do
se gadolinium (,2 to .4 mmol/kg) for magnetic resonance imaging were r
eviewed to identify patients who had also received iodinated contrast
for radiographic examinations. Their clinical course and laboratory da
ta were reviewed to identify changes in serum creatinine attributable
to the contrast agents, In 64 patients, serum creatinine data were ava
ilable pre and post both gadolinium and iodinated contrast. The mean c
hange in serum creatinine after gadolinium in these 64 patients was -,
07 mg/dL (-6 mu mol/L). By comparison, the mean change in serum creati
nine in the same patients after iodinated contrast was .35 mg/dL (+31
mu mol/L) from 2.0+/-1.4 to 2.3+/-1.8 (P=.002), Eleven of the 64 patie
nts had iodinated contrast-induced renal failure (.5 mg/dL or greater
rise in serum creatinine); none had gadolinium contrast-induced renal
failure despite the high gadolinium dose and high prevalence of underl
ying renal insufficiency. High-dose gadolinium chelates are significan
tly less nephrotoxic than iodinated contrast.