RENAL EFFECTS OF NONIONIC CONTRAST-MEDIA AFTER CARDIOANGIOGRAPHY

A prospective double-blind randomized cardioangiographic study with io pentol and iohexol was performed in 60 patients. Glomerular filtration rate (GFR) was assessed by serum values of creatinine and beta(2)-mic roglobulin (beta(2)-MG), estimated creatinine clearance (C-Cr) accordi ng to COCKROFT & GAULT'S formula, and 24 hour C-Cr. The urinary excret ion of albumin, beta(2)MG, and of the renal tubular enzymes alkaline p hosphatase (ALP) and N-acetyl-beta-glucosaminidase (NAG) was also meas ured. Contrary to what has been found after i.v. injections, GFR was r educed by both nonionic contrast media. Serum creatinine (S-Cr) was in creased by more than 25% in 6 patients, 3 in each group. C-CR was more sensitive than S-Cr and S-beta(2)-MG, but this method is less precise because of risk of urine sampling errors. Estimated C-Cr gave no addi tional information to S-Cr. The urinary excretion of NAG and ALP was i ncreased. No clinically significant differences between iopentol and i ohexol were detected. No correlation was found between the changes in tubular function parameters and changes in GFR. Twenty patients were o n calcium channel blockers before the investigation, but this had no p rotective effect on the renal function parameters.