Electrocardiographic changes during intravenous urography: A study with sodium iothalamate and iohexol

Heron, Christine; Underwood, S. R.; Dawson, Peter

doi:10.1016/s0009-9260(84)80016-1

Cited by 17 publications

(6 citation statements)

References 30 publications

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“…Our study confirms and extends, to the largest number of measurements with iohexol currently available, the assumption that an injection of a low dose of iohexol (5–10 mL) is safe and, specifically, that no anaphylactic reaction occurs [16, 32-34]. Moreover, the fact that iohexol injection has been repeated in the follow-up of the patients without any problem is additional proof of the safety of the procedure.…”

Section: Discussionsupporting

confidence: 83%

Safety of Iohexol Administration to Measure Glomerular Filtration Rate in Different Patient Populations: A 25-Year Experience

Gaspari

Thakar

Carrara

et al. 2018

Nephron

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Background/Aim: In clinical research setting, accurate and precise measurement of glomerular filtration rate (GFR) is essential to overcome the limitations of GFR estimation with equations, which are often unreliable. In recent decades, a method for measuring GFR by plasma clearance of iohexol, a non-ionic radiocontrast agent, was developed. To evaluate the safety of the procedure, we aimed to review all immediate adverse reactions that could be related to iohexol administration in our group’s 25 years worth of experience. Methods: We retrospectively reviewed all GFR investigations in 2,891 patients, between 1992 and 2016, as part of 37 clinical trials coordinated by our group. Subjects with disparate renal diseases, kidney transplant recipients, and living donors – all with different renal function categories – were included in the surveyed clinical trials. Results: During 15,147 GFR measurements, only one treatment-related event of moderate intensity was identified. Flushing, urticaria, and itching were observed in a diabetic patient a few minutes after iohexol administration during the first GFR measurement. The event recovered without sequelae after intravenous injection of methylprednisolone sodium succinate. The patient was not hospitalized and the event was categorized as non-serious. Eight additional non-serious events observed closely following iohexol injection were considered as not related to treatment. Thus, independent of disease conditions and GFR categories, the overall rate of treatment-related events was 0.0066%. Conclusion: Iohexol administration for GFR measurement is a safe procedure, even in repeated investigations in the same subject, that should be adopted in clinical research and, when needed, also in clinical practice.

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Section: Discussionsupporting

confidence: 83%

Safety of Iohexol Administration to Measure Glomerular Filtration Rate in Different Patient Populations: A 25-Year Experience

Gaspari

Thakar

Carrara

et al. 2018

Nephron

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“…The safety of iohexol has been extensively studied [ 44 , 45 ] and is confirmed by the large number of iohexol measurements performed in countries, e.g. Sweden (in Skåne county) (∼1500 GFR measurements/year) [ 46 , 47 ] and Italy (25 000 iohexol clearances since 1995 at the Clinical Research Center of Mario Negri Institute in Bergamo) (F.G., personal data).…”

Section: Iohexol: General Properties and Safetymentioning

confidence: 96%

Iohexol plasma clearance for measuring glomerular filtration rate in clinical practice and research: a review. Part 1: How to measure glomerular filtration rate with iohexol?

et al. 2016

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While there is general agreement on the necessity to measure glomerular filtration rate (GFR) in many clinical situations, there is less agreement on the best method to achieve this purpose. As the gold standard method for GFR determination, urinary (or renal) clearance of inulin, fades into the background due to inconvenience and high cost, a diversity of filtration markers and protocols compete to replace it. In this review, we suggest that iohexol, a non-ionic contrast agent, is most suited to replace inulin as the marker of choice for GFR determination. Iohexol comes very close to fulfilling all requirements for an ideal GFR marker in terms of low extra-renal excretion, low protein binding and in being neither secreted nor reabsorbed by the kidney. In addition, iohexol is virtually non-toxic and carries a low cost. As iohexol is stable in plasma, administration and sample analysis can be separated in both space and time, allowing access to GFR determination across different settings. An external proficiency programme operated by Equalis AB, Sweden, exists for iohexol, facilitating interlaboratory comparison of results. Plasma clearance measurement is the protocol of choice as it combines a reliable GFR determination with convenience for the patient. Single-sample protocols dominate, but multiple-sample protocols may be more accurate in specific situations. In low GFRs one or more late samples should be included to improve accuracy. In patients with large oedema or ascites, urinary clearance protocols should be employed. In conclusion, plasma clearance of iohexol may well be the best candidate for a common GFR determination method.

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“…Actually, the relative importance of this extra-renal clearance will be higher when the GFR is yet low (Visser et al, 2008). Iothalamate is a safe product but, of course, it will be not used in subjects presenting a known "true" allergy to contrast products (Heron et al, 1984). Regarding the isotopic method, the radioactive dose got by the patient is also very low (lower than the dose got for thorax radiography) (Hall & Rolin, 1995;Bajaj et al, 1996).…”

Section: Physiological and Analytical Datamentioning

confidence: 99%

“…We will not discuss into details the other methods for measuring iohexol: capillary electrophoresis (Shihabi & Constantinescu, 1992) and mass spectrometry (Lee et al, 2006;Annesley & Clayton, 2009;Denis et al, 2008;Stolz et al, 2010). The safety of iohexol is now confirmed (Heron et al, 1984;Aurell, 1994), notably by the largest series of iohexol measurements in Sweden (1500 GFR measurements/y) (Nilsson-Ehle & Grubb, 1994;Nilsson-Ehle, 2002). This safety profile is, at least in part, explained by the low dose of iohexol injected, and by the exclusion of patients with contrast products allergy.…”

Section: Physiological and Analytical Datamentioning

confidence: 99%

How Measuring Glomerular Filtration Rate? Comparison of Reference Methods

Delanaye¹

2012

Basic Nephrology and Acute Kidney Injury

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Electrocardiographic changes during intravenous urography: A study with sodium iothalamate and iohexol

Cited by 17 publications

References 30 publications

Safety of Iohexol Administration to Measure Glomerular Filtration Rate in Different Patient Populations: A 25-Year Experience

Safety of Iohexol Administration to Measure Glomerular Filtration Rate in Different Patient Populations: A 25-Year Experience

Iohexol plasma clearance for measuring glomerular filtration rate in clinical practice and research: a review. Part 1: How to measure glomerular filtration rate with iohexol?

How Measuring Glomerular Filtration Rate? Comparison of Reference Methods

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