Objective: Several strategies have been employed to reduce the incidence of
nephrotoxicity in connection with the administration of urographic contras
t media. We present the results of a randomized study to explore the effect
of a single hemodialysis treatment immediately after an angiographic exami
nation. Material and methods: The patients studied had moderately reduced r
enal function. Seventeen of the 32 patients had diabetic nephropathy and 15
had other renal diseases. They were randomly selected to undergo either he
modialysis or standard treatment following the angiographic examination. Th
e glomerular filtration rate (GFR) was determined the day before and I week
after administration of the contrast medium. All patients were hydrated an
d received oral calcium-channel blocking treatment before angiography. Resu
lts: Hemodialysis lowered the level of contrast medium in plasma by approxi
mately 80%. In spite of this no significant difference in renal iohexol cle
arance was noted between groups treated and not treated with hemodialysis.
Conclusions: The risk of a marked and sustained reduction in renal function
after administration of an iodine contrast medium is low with modern angio
graphic techniques. Hemodialysis reduces levels of contrast media in plasma
but does not reduce the incidence of contrast-medium induced nephrotoxicit
y in the GFR range from 10 to 25 ml/min.