Efficacy and Safety of Iopromide for Excretory Urography

Newhouse, Jeffrey H.; Landman, Jaime; Lang, Erich K.; Amis, Edward S.; Goldman, Stanley; Khazan, Ron; Hedgcock, Marcus W.

doi:10.1097/00004424-199405001-00013

Cited by 11 publications

(7 citation statements)

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“…[5] With low osmolar contrast medium (LOCM) for IVP, none of the patients experienced a CM related increase in serum creatinine. [67] In a recent study comparing iodixanol and ioversol for IVP, one out of 25 patients in each arm developed contrast nephropathy. [8] A comparison between iodixanol and iomeprol for abdominal CT revealed a significantly lower incidence of CIN with iomeprol as compared with iodixanol (6.9% vs.…”

Section: Cin In Urological Imagingmentioning

confidence: 99%

Contrast induced nephropathy in urology

Thomson¹,

Narayanan²,

Singh³

2009

Indian J Urol

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Intravenous contrast agents have a distinct role in urological imaging: to study precise anatomical delineation, vascularity, and to assess the function of the renal unit. Contrast induced nephropathy (CIN) is a known adverse effect of intravenous contrast administration. The literature on incidence, pathophysiology, clinical features, and current preventive strategies available for CIN relevant to urologists was reviewed. A search of the PubMed database was done using the keywords nephropathy and media, prevention and control or prevention Contrast media (explode), all adverse effects, and kidney diseases (explode). An online search of the EMBASE database for the time ranging from 1977 to February 2009 was performed using the keywords ionic contrast medium, adverse drug reaction, major or controlled clinical study, human, nephrotoxicity, and kidney disease. Current publications and data most relevant to urologists were examined. CIN was the third most common cause of hospital-acquired renal failure. The incidence is less common with intravenous contrast administration as compared with intra-arterial administration. The pathogenesis of contrast mediated nephropathy is due to a combination of toxic injury to renal tubules and medullary ischemic injury mediated by reactive oxygen species. CIN most commonly manifests as a nonoliguric and asymptomatic transient decline in renal function. Patients who developed CIN were found to have increased mortality, longer hospital stay, and complicated clinical course. An overview of risk factors and risk prediction score for prognostication of CIN are elaborated. Preventive strategies including choice of contrast agents, maximum tolerated dose, role of hydration, hydration regime, etc. are discussed. The role of N- acetyl cysteine, Theophylline, Fenoldapam, Endothelin receptor antagonists, iloprost, atrial natriuretic peptide, and newer therapies such as targeted renal therapy (TRT) are discussed. A working algorithm based on current evidence is proposed. No current treatment can reverse or ameliorate CIN once it occurs, but prophylaxis is possible.

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Section: Cin In Urological Imagingmentioning

confidence: 99%

Contrast induced nephropathy in urology

Thomson¹,

Narayanan²,

Singh³

2009

Indian J Urol

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“…Rankin and Eng (1982) reported no incidence of CIN in their study of 220 patients who received intravenous LOCM. 6 Similarly, Newhouse et al (1994) in their study of 200 patients. 7 have also reported nil incidence of CIN, while Moore et al (1992) reported CIN in three (1.2%) of 250 subjects receiving intravenous LOCM.…”

Section: Resultsmentioning

confidence: 90%

“…6 Similarly, Newhouse et al (1994) in their study of 200 patients. 7 have also reported nil incidence of CIN, while Moore et al (1992) reported CIN in three (1.2%) of 250 subjects receiving intravenous LOCM. 8 In a retrospective study of 594 patients who received intravenous LOCM, Kragha K.O.…”

Section: Resultsmentioning

confidence: 90%

Risk of Contrast Induced Nephropathy With Intravenous Administration

Sharma¹,

Jayaprakash²

2015

jemds

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ABSTRACT:With the increasing use of iodinated contrast media for CT Scan and other radiologic procedures, contrast induced nephropathy (CIN) has emerged as an important delayed adverse effect due the intravascular administration of contrast media. OBJECTIVES: To study the incidence of CIN in patients undergoing intravenous contrast enhanced CT (CECT) scans and to assess the safety of iodinated, low osmolar contrast media (LOCM) in such patients. MATERIALS AND METHODS: We conducted a study in 182 patients who received intravenous low osmolar contrast media to assess the risk of CIN in patients undergoing diagnostic CECT. All the patients had a baseline serum creatinine (SeCr) value done prior to the procedure, and were then followed up with a repeat SeCr at 48 to 72hrs, and where necessary, on day 5 to 7 after the procedure. RESULTS: Thirty eight patients (20.9%) showed no change in their baseline SeCr value at 48 hrs. after contrast administration, while 13 patients (7.1%) showed a slight decrease, and 131 patients (72%) showed an increase in SeCr. None of the patients showed a greater than 0.5mg/dL increase in the SeCr, while 3 patients (1.6%) showed a 25% increase in the 48 hrs. SeCr from baseline value. CONCLUSION: The incidence of CIN varied from 0 to 1.6% depending on the definition used. Contrast induced nephropathy is a rare complication of intravenous administration of contrast media. LOCMs can be safely used in the general population who do not have pre-existing renal impairment or other major risk factors.

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“…This finding highlights the importance of prerenal factors, such as hypotension due to blood loss, and the distinct possibility that CM-induced hypovolemia secondary to nonspecific osmotic diuresis could contribute to CIN in some cases. (20) all reported the average increase in SCr levels among patients without preexisting renal insufficiency who received an intravenous LOCM. A total of 599 patients are reported on in these studies, none of which revealed a substantial increase in average SCr level following CM administration.…”

Section: Studies With (Control) Subjects Who Did Not Receive CMmentioning

confidence: 99%