Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

Histomorphological changes after renal X-ray arteriography using iodine and gadolinium contrast media in an ischemic porcine model

“…These test solutions have an osmolality 5.5 to 7 times that of plasma, and the frequency and severity of the changes they induced were significantly higher than those caused by the test solutions with lower osmolality, i.e., 1.0-2.7 times that of plasma. Gadopentetate, mannitol/io 1.96, and gadobutrol also caused severe impairment of renal function, while animals subjected to the other test solutions had much less effect on GFR, as reported separately (Table 1) (14)(15)(16). These findings indicate that osmolality was the predominant factor for inducing necrosis, hemorrhage/congestion, and severe renal impairment.…”

“…ARF is caused by ischemic (50%) or nephrotoxic (35%) injury to the kidney, and is often multifactorial (27). In the present porcine model, the marked necrosis of proximal tubules paralleled severe impairment of renal function (14,16), and it can be postulated that the mechanisms behind these changes probably include, as in human ARF, ischemic and toxic effects of CM.…”

Surgical treatment of aortoiliac aneurysms in renal transplant patients

“…22 Both iodinated contrast and gadolinium have been shown to be nephrotoxic. 23,24 For that reason, contrast doses should be kept as low as possible and associated with adequate intravenous hydration and diuretics to maintain a satisfactory urinary output.…”

Prospects of molybdenum and rhenium octahedral cluster complexes as X-ray contrast agents

“…The 2 also showed significant radiopacity and the chemistry of {Re 6 Se 8 }-based compounds at present is studied well enough to create highly water soluble compounds with properties suitable for use as X-ray It is important to note, that to date the most utilized alternative to iodinated contrast media are gadolinium-based preparations (Gd (Z = 64)). However, Gd-based agents as radiocontrast media [20,21] are used very rarely, because these agents may cause severe adverse reactions, especially at high doses used for X-ray diagnostics (e.g., CT and conventional angiography) [22][23][24][25][26][27]. Furthermore, several research groups have shown that X-ray contrast of Gd-based agents is from four to eight times weaker than that of I-based ones taken with equal concentration of the heavy element [24,28,29].…”