COMPARISON OF A LOW OSMOLARITY NONIONIC RADIOGRAPHIC CONTRAST AGENT WITH A STANDARD MEDIUM ON RENAL-FUNCTION IN CYANOTIC AND NORMAL DOGS

Renal dysfunction may follow administration of iodinated radiographic contrast agents. This complication may be less common when low osmolar ity nonionic agents are used. Although potential benefits from the use of low osmolarity nonionic contrast may be minimal in individuals wit h normal physiology, a greater benefit has been postulated in the pres ence of chronic cyanosis. To test this hypothesis, six adult mongrel d ogs underwent anastomosis of the inferior vena cava to the left atrium . This produced chronic cyanosis with a mean pO(2) of 48 +/- 4 mm Hg a nd polycythemia with a mean hematocrit of 56 +/- 2 gm%. Three to 5 mon ths after preparation, these cyanotic dogs and five control dogs each received diatrizoate (a high osmolarity ionic agent) or ioversol (a lo w osmolarity nonionic agent), 465 mg iodine/kg body weight, by intrave nous bolus injection. One month later, each animal received the other agent. The order of administration was randomized. Renal function stud ies, including serum creatinine and creatinine clearance, were perform ed precontrast, after 60 min, and 24 hr postcontrast. Neither agent ad versely affected renal function in either the cyanotic or the normal g roup. We conclude that at the doses that are commonly used in clinical practice, high osmolarity ionic contrast agents do not create a great er risk of renal injury than do low osmolarity nonionic agents in this model of cyanosis. (C) 1994 Wiley-Liss, Inc.