IOPENTOL IN PATIENTS WITH CHRONIC-RENAL-FAILURE - ITS EFFECTS ON RENAL-FUNCTION AND ITS USE AS GLOMERULAR-FILTRATION RATE PARAMETER

Iopentol (mean dose 0.42 g I kg-1) was administered for abdominal aort ography and pelvic angiography in 10 patients with advanced non-diabet ic chronic renal failure (S-creatinine 672 +/- 259-mu-mol l-1, mean +/ - SD). Renal glomerular function measured as creatinine clearance and plasma clearance of [Tc-99(m)]-diethylenetriaminepentaacetic acid (DTP A) was unchanged by iopentol, as also was urinary excretion of the ren al tubular enzymes N-acetyl-beta-glucosaminidase (NAG) and alkaline ph osphatase (ALP). The elimination of iopentol from serum and urine was delayed, and detectable serum and urine concentrations were found 5 da ys after administration of the contrast medium. Creatine clearance was 47% higher than the corresponding renal iopentol clearance. Plasma io pentol clearance, measured as the total area under the plasma concentr ation curve, was 40% higher than renal iopentol clearance because of e xtrarenal elimination of iopentol. We conclude that abdominal aortogra phy with iopentol can be performed without effects on renal glomerular or tubular function parameters in patients with advanced renal failur e. If iopentol is used for measurement of glomerular filtration rate ( GFR) in this group of patients, one should measure renal clearance, as plasma clearance overestimates GFR.