Low risk of contrast-medium-induced nephropathy with modern angiographic technique

Objective and design. A retrospective study of the incidence of contrast-me dium-induced nephropathy (CMN) in patients with renal insufficiency. Subjects. All angiographies with and without endovascular therapeutic proce dures (n = 2400) performed at the hospital during 1 year were evaluated. A total of 139 patients were found to have a preangiographic serum-creatinine (s-Cr) of 150 mu mol L-1 or above. Postprocedural serial s-Cr values were present in 118 patients and these were included in the study. Results. Amongst patients receiving only iodinated contrast media (CM) 8% d emonstrated a 25% rise in s-Cr. The corresponding figure was 11 and 12.5% a mongst patients who were given either iodinated CM together with carbon dio xide (CO2) or CO2 as sole contrast medium. After exclusion of other explana tions of impaired renal function all together only seven of 114 patients (6 %) were considered to have developed CMN. Four of the seven patients restit uted renal function completely, whilst it remained decreased in three. No p atient required dialysis. The percentage of diabetic patients were not foun d to be different in patients with and without signs of CMN. Conclusions. The present retrospective study indicate that the risk of CMN in connection with angiography is low when modern low-osmolality CM and con trast saving angiographic technique including CO2 is used combined with pro per hydration. Patients with diabetes mellitus were not found more frequent ly in the groups with CMN.