Influence of dialysis procedure, membrane surface and membrane material oniopromide elimination in patients with reduced kidney function

Haemodialysis for the elimination of contrast medium in patients with advan ced renal failure is a common procedure. Even though sufficient elimination with the use of regular low-flux membranes is documented, large difference s in results have been reported in prior investigations. We, therefore, com pared Cuprophan and polysulfone dialysers with different surface areas to h aemofiltration with different amounts of substitution fluid in 40 patients with compromised renal function after coronary angiography. Plasma iodine c oncentrations were measured by fluorescent excitation analysis. At constant blood flow rates of 200 ml/min, Cuprophan membranes with 1.3 m(2) surface area had a clearance rate of 87 ml/min, whereas polysulfone membranes of co mparable size displayed a significantly higher clearance rate of 147 ml/min . Polysulfone membranes with 1.8 m(2) surface area showed a small but insig nificant increase in the iodine clearance (162 ml/min), while Cuprophan mem branes displayed an increase in clearance rates (121 mil min). Additional u ltrafiltration led to a further increase in the plasma clearance of both me mbranes and reduced urinary iodine excretion, Haemofiltration was comparabl e to haemodialysis in terms of efficacy and thus represents an alternative method, Clearance of iopromide during haemodialysis with polysulfone membra nes is higher than with Cuprophan membranes, Elimination rates can be furth er increased by additional ultrafiltration. Haemofiltration is comparable t o haemodialysis regarding contrast medium elimination. Copyright (C) 2000 S . Karger AG, Basel.