EFFECT OF HEMODIALYSIS AFTER CONTRAST-MEDIUM ADMINISTRATION IN PATIENTS NIFH RENAL-INSUFFICIENCY

Background. The study was designed to investigate the influence of hae modialysis on the pharmacokinetics of the non-ionic contrast medium io pentol and the outcome of radiocontrast nephropathy in patients at ris k undergoing angiography. Methods. We prospectively studied 30 patient s with reduced renal function (mean serum creatinine concentration (+/ - SEM), 2.4 +/- 0.16 mg/dl (212 +/- 14 mu mol/l)). Patients were rando mly assigned to receive either a haemodialysis procedure for 3 h, star ted as soon as possible (63 +/- 6 min) after administration of contras t medium, or a conservative treatment. Serum concentrations of iopento l and creatinine were followed for up to 14 days. Results. The extraco rporal plasma clearance of contrast medium was 71 +/- 2.5 ml/min. The fraction of the dose eliminated was 32 +/- 3%. The rate of radiocontra st nephropathy (defined as serum creatinine increase of greater than o r equal to 0.5 mg/dl (44 mu mol/l) within 48 h) after administration o f contrast medium was similar in both groups (53 and 40% in group 1 (h aemodialysis) and group 2 (conservative treatment) respectively). The course of absolute changes in serum creatinine over the whole observat ion period was not different in both groups. Conclusions. The data ind icate that haemodialysis eliminates contrast medium effectively, but i t may not influence the incidence or outcome of contrast induced nephr opathy.