COMPARISON BETWEEN THE EFFICACY OF DIMERIC AND MONOMERIC NONIONIC CONTRAST-MEDIA (IODIXANOL VS IOPROMIDE) IN UROGRAPHY IN PATIENTS WITH MILD-TO-MODERATE RENAL-INSUFFICIENCY

Non-ionic dimers induce less diuresis than non-ionic monomers, resulti ng in increased opacification of the urinary tract in intravenous (iv) urography. This double blind, comparative, randomized, parallel trial compared the efficacy of iodixanol (non-ionic dimer) and iopromide (n on-ionic monomer) in 100 patients with mild to moderate renal insuffic iency (serum creatinine of 135 to 265 mu mol l(-1)) who underwent iv u rography. A total dose of 600 mgI kg(-1) bw of iodixanol (320 mgI ml(- 1)) or iopromide (300 mgI ml(-1)) was injected. Radiographs were blind ly evaluated by three radiologists who analysed different parameters ( renal border visualization, nephrogram density, calyceal filling and d ensity, papillary blush detection, delineation of collecting ducts, re nal pelvis opacification, visualization of ureters, bladder density, b ladder distention). Densitometric evaluation on the renal pelvis and b ladder was also performed. Iodixanol showed better filling and density of the calyces (p = 0.004), more frequent detection of papillary blus h (p = 0.003) and better opacification of the renal pelvis (p = 0.006) . No significant differences between the two contrast media were found in regard to other parameters. In conclusion, the results confirmed t heoretical expectations. The non-ionic dimer iodixanol is to be prefer red to a non-ionic monomer such as iopromide in iv urography on patien ts with impaired renal function.