Contrast-induced nephropathy in outpatients with preexisting renal impairment: a comparison between intravenous iohexol and iodixanol

Cernigliaro, Joseph G.; Haley, William E.; Adolphson, Doug P.; Jepperson, Maria A.; Crook, Julia E.; Thomas, Colleen S.; Parker, Alexander S.

doi:10.1016/j.clinimag.2016.04.008

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…Although we did not detect any significant differences in post-CT outcomes between contrast exposure groups after propensity score adjustment, several material, iohexol, and these policies are adhered to well by ordering providers. The purpose of our study was not to specifically compare PC-AKI rates between iodixanol and other low-osmolar contrast materials, because numerous prior studies have performed this comparison (16)(17)(18)(19)(20)(21). Instead, we focused on a patient cohort that we believe was at higher perceived risk of PC-AKI because of the decision to administer iodixanol instead of iohexol.…”

Section: Paired Analysis Of Patients Who Underwent Both Iocm-enhancedmentioning

confidence: 99%

Is Intravenous Administration of Iodixanol Associated with Increased Risk of Acute Kidney Injury, Dialysis, or Mortality? A Propensity Score–adjusted Study

McDonald

Williamson

et al. 2017

Radiology

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Purpose To compare the rates of acute kidney injury (AKI), emergent dialysis, and short-term mortality between patients who underwent intravenous administration of the iso-osmolar contrast material (IOCM) iodixanol 320 and patients who underwent a noncontrast computed tomography (CT) examination. Materials and Methods Study design and implementation were overseen by an institutional review board and conformed to HIPAA guidelines on patient data integrity. All patients who underwent an iodixanol-enhanced (IOCM group) or a noncontrast (noncontrast group) CT examination from January 2003 to December 2014 were identified. Patients were subdivided into subgroups of those with stage 1-2 chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR], ≥ 60 mL/min/1.73 m), those with stage 3 CKD (eGFR, 30-59 mL/min/1.73 m), and those with stage 4-5 CKD (eGFR < 30 mL/min/1.73 m) and separately underwent propensity score stratification and matching. Rates of AKI, emergent dialysis, and mortality were compared between IOCM and noncontrast groups. Additional analyses incorporating intravenous fluid administration, including additional CT studies at other sites within a single institution, and a paired analysis of patients who underwent both IOCM and noncontrast CT studies during the study time frame, were also performed. Results A total of 5758 patients (1538 with stage 1-2 CKD, 2899 with stage 3 CKD, and 1321 with stage 4-5 CKD) were included in the study. After propensity score adjustment, rates of AKI, dialysis, and mortality were not significantly higher in the IOCM group compared with the noncontrast group for all CKD subgroups (AKI odds ratios [ORs], 0.74-0.91, P = .16-0.69; dialysis ORs, 0.74-2.00, P = .42-.76; mortality ORs, 0.98-1.24, P = .39-.88). Sensitivity analyses yielded similar results. Conclusion Among patients at the highest perceived risk of postcontrast AKI, intravenous administration of iodixanol for contrast material enhanced CT was not an independent risk factor for AKI, dialysis, or mortality. RSNA, 2017 Online supplemental material is available for this article.

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Section: Paired Analysis Of Patients Who Underwent Both Iocm-enhancedmentioning

confidence: 99%

Is Intravenous Administration of Iodixanol Associated with Increased Risk of Acute Kidney Injury, Dialysis, or Mortality? A Propensity Score–adjusted Study

McDonald

Williamson

et al. 2017

Radiology

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“…Although one study successfully adopted 15 mL/kg iohexol combined with dehydration plus furosemide (10 mL/kg) to establish CIN rat model [ 19 ], based on the principle of emphasizing the importance of minimizing the dose of CM in clinical practice, LOCM (iohexol, 10 mL/kg) combined with the proper pretreatment is enough to construct male mice model with CI-AKI. Besides, although iohexol is widely used in clinic practice, other common types, such as iodixanol [ 32 ] , need to be also further explored. At last, the time selection after the UPHT has a wide range of options between 2 and 4 weeks [ 30 , 33 , 40 ], mostly 3 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, considering that iohexol as a nonionic low-osmolar contrast media (CM) is widely used in hospitals [ 32 ], we chose it as a representative CM in our study and aimed to establish a novel reliable and reproducible LOCM-induced AKI model in male mouse comparable to the human contrast-induced nephropathy. Different dehydration treatments with UPHT were attempted to explore reliable preparatory conditions for CI-AKI mouse model construction, which were verified in vivo subsequently.…”

Section: Introductionmentioning

confidence: 99%

A novel contrast-induced acute kidney injury mouse model based on low-osmolar contrast medium

Shen

Wang³

et al. 2022

Renal Failure

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The contrast-induced acute kidney injury (CI-AKI) has been becoming the third common cause of hospital-acquired acute kidney injury. An ideal animal model is essential for understanding the pathophysiology of CI-AKI. Previous CI-AKI studies were mostly performed on rats with high-osmolar contrast medium (HOCM), which is unsuitable for transgenic researches. This study provides a novel, efficient and reproducible CI-AKI model which was developed in mouse by administrating a low-osmolar contrast medium (LOCM). First of all, we applied the frequently used pretreatments (uninephrectomy and water deprivation), which combined with HOCM on rats could induce CI-AKI, on mice with LOCM. Secondly, we attempted to find a novel pretreatment suitable for mouse and LOCM by combining two classic pretreatments(uninephrectomy, water deprivation and furosemide administration). Finally, we evaluate the kidney damage of the novel model. We found that this mouse model possessed a significant reduction in renal function, severe renal tissue damage, and increased renal tubular cells apoptosis, indicating that LOCM is a feasible inducer for CI-AKI mice model. Taken together, we found that uninephrectomy (UPHT) combined with 24 h water deprivation and furosemide administration 20 min before LOCM (iohexol, 10 ml/kg) application is a feasible pretreatment to establish a novel CI-AKI mouse model.

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“…Although there is currently no consensus regarding the degree of threat posed by contrast-induced acute kidney injury (CIAKI), there is an increasing understanding that lower baseline estimated glomerular filtration rate (eGFR) and hydration status are potentially the most relevant predictors of this complication (17, 18). It is certainly a factor to be considered in the use of pre-procedural contrast-enhanced MDCT; however, the ability of MDCT to delineate the access anatomy, including the site and degree of any significant calcification, and to provide accurate aortic dimensions is an invaluable procedural planning aid.…”

Section: Peri-procedural and General Considerations In The Use Of Toementioning

confidence: 99%

3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?

Bleakley¹,

Eskandari²,

Monaghan³

2017

Echo Research and Practice

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Transcatheter aortic valve implantation (TAVI) was initially proven as an alternative to valve replacement therapy in those beyond established risk thresholds for conventional surgery. With time the technique has been methodically refined and offered to a progressively lower risk cohort, and with this evolution has come that of the significant imaging requirements of valve implantation. This review discusses the role of transoesophageal echocardiography (TOE) in the current TAVI arena, aligning it with that of cardiac computed tomography, and outlining how TOE can be used most effectively both prior to and during TAVI in order to optimise outcomes.

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Contrast-induced nephropathy in outpatients with preexisting renal impairment: a comparison between intravenous iohexol and iodixanol

Cited by 9 publications

References 29 publications

Is Intravenous Administration of Iodixanol Associated with Increased Risk of Acute Kidney Injury, Dialysis, or Mortality? A Propensity Score–adjusted Study

Is Intravenous Administration of Iodixanol Associated with Increased Risk of Acute Kidney Injury, Dialysis, or Mortality? A Propensity Score–adjusted Study

A novel contrast-induced acute kidney injury mouse model based on low-osmolar contrast medium

3D transoesophageal echocardiography in the TAVI sizing arena: should we do it and how do we do it?

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