EFFECT OF IODIXANOL ON RENAL-FUNCTION IMMEDIATELY AFTER ABDOMINAL ANGIOGRAPHY - CLINICAL COMPARISON WITH IOMEPROL AND IOXAGLATE

Purpose: To investigate the acute renal effects of three contrast medi a in a double-blind randomized parallel-group study. The contrast medi a investigated were: the nonionic dimeric iso-osmolality medium iodixa nol; the nonionic monomeric medium iomeprol; and the ionic dimeric med ium ioxaglate. Material and Methods: A total of 30 patients were given the following doses of contrast medium: 10 patients received iodixano l 320 mg I/ml; 10 received iomeprol 300 mg I/ml; and 10 received ioxag late 320 mg I/ml. The doses were given intra-arterially at routine abd ominal angiography and the renal effects of these three contrast media were studied for up to 120 min after injection. Results: The urinary minute volume increased immediately after angiography but tended to re turn to baseline values after 120 min; these changes were more pronoun ced with iomeprol and ioxaglate than with iodixanol. Creatinine cleara nce was not reduced by any of the contrast media. Fraction excretion o f sodium increased immediately and lasted for 30 min after angiography ; these changes were more pronounced with ioxaglate than with iomeprol and iodixanol. Urinary gamma-glutamyl transferase increased for 120 m in after angiography with iodixanol and iomeprol; these changes were m ore pronounced with iomeprol than with iodixanol. On the other hand, u rinary N-acetyl-beta-glucosaminidase increased for 120 min after angio graphy with iomeprol, but was unchanged with iodixanol. Conclusion: Th e use of contrast media induces osmotic diuresis and its acute effects on the proximal tubular function. However, the iso-osmolality medium iodixanol induces fewer changes than the other two media.