No Increased Risk for Contrast-Induced Nephropathy after Multiple CT Perfusion Studies of the Brain with a Nonionic, Dimeric, Iso-Osmolal Contrast Medium

Article Figures & Data

Table 1.

Demographic data of patients and control subjects

Data	Iodixanol Group	Control Group	P Value
Patients
Men	52	52
Women	48	48
Mean age (years ± SD)	65.4 ± 13.9	67.1 ± 16.5.2
Mean baseline SCr (mg/dL)/(μmol/L ± SD)	0.96 ± 0.35/85 ± 31.11	1.14 ± 0.74/101 ± 65.4	.082
Risk factors for CIN
Pre-existing renal impairment (see Table 2)	7	13	.071
Hypertension	68	57	.072
Diabetes mellitus	41	46	.088
Coronary artery disease	56	50	.239
Hypercholesterolemia	55	51	.335
Hyperuricemia	2	0	.249
Diuretics	5	7	.197
Concomitant use of diuretic and ACE inhibitor	5	7	.197
Nephrotoxic drugs (eg, NSAIDs)	12	8	.240

Note:—CIN indicate contrast-induced nephropathy; ACE, angiotensin-converting enzyme; NSAIDs, nonsteroidal anti-inflammatory drugs; SCr, serum creatinine.

Table 2.

SCr of patients with elevated baseline SCr Greater than or equal to 1.5 mg/dL

Patient No.	Baseline SCr (mg/dL)	First Postcontrast SCr (mg/dL)	Second Postcontrast SCr (mg/dL)
Control Group
2	1.67	1.76	2.04
6	1.61	1.35	1.17
15	1.54	0.67	1.07
28	4.97	5.21	3.90
29	4.04	4.59	4.77
39	2.74	2.70	2.81
41	2.13	2.14	2.09
55	2.02	1.31	1.48
57	2.50	1.98	2.78
67	2.73	2.14	2.57
74	3.29	2.88	3.43
76	2.08	2.16	2.73
78	1.98	0.76	1.50
Patient Group
54	1.66	1.33	1.41
57	1.86	1.44	1.06
69	1.76	1.43	1.62
74	1.63	1.62	1.70
81	1.72	1.48	1.72
78	1.56	1.37	1.69
85	2.87	1.90	1.20

Table 3.

SCr in the iodixanol and control group

	Iodixanol Group	Control Group
Mean baseline (mg /dL ± SD)	0.96 ± 0.35	1.14 ± 0.74
Minimum baseline (mg/dL)	0.45	0.41
Maximum baseline (mg/dL)	2.8	4.97
Mean first postcontrast SCr (mg /dL ± SD)	0.84 ± 0.3	1.07 ± 0.77
Minimum first postcontrast (mg/dL)	0.37	0.29
Maximum first postcontrast (mg/dL)	1.9	5.21
Mean second postcontrast SCr (mg/dL ± SD)	0.84 ± 0.31	1.11 ± 0.76
Minimum second postcontrast (mg/dL)	0.37	0.37
Maximum second postcontrast (mg/dL)	1.72	4.77

Table 4.

Patients with contrast-induced nephropathy

Patient No.	Baseline SCr (mg/dL)	First Postcontrast SCr (mg/dL)	Second Postcontrast SCr (mg/dL)
Control Group
12^†	1.00	1.04	1.38
20^†	0.69	0.80	0.87
22^†	0.40	0.44	0.60
29^*,^‡	4.04	4.59	4.77
43^†	1.30	1.53	2.19
46^†	0.48	0.76	0.79
60^†	0.88	1.10	1.22
61^†	0.84	1.28	1.92
63^†	1.06	1.00	1.38
73^†	1.32	1.30	1.73
75^†	0.79	0.94	1.11
76^†,^*	2.08	2.16	2.73
Patient Group
30^†	0.51	0.58	0.66
42^†	0.94	1.29	1.38
47^†	0.71	0.64	0.89
48^†	0.63	0.58	0.88
58^†	1.11	1.13	1.39
70^†	0.58	0.67	0.79
83^†	0.62	0.75	0.86

Table 5.

Clinical studies with intravenous LOCM

Study	Year of Publication	Contrast Medium	No. of Subjects	Criterion for CIN	Outcome
Barrett²³	2006	Iopamidol, Iodixanol	153	increase ≥0.5 mg/dL in SCr	CIN in 3% (2 subjects) of iodixanol-group
Becker³⁷	2005	Iodixanol	100	>0.5 mg/dL increase in SCr	CIN in 9%
Kolehmainen²⁵	1998	Iobitridol, iodixanol	50	≥0.5 mg/dL increase in SCr	CIN in 4 of 25 subjects in each group
Tepel³²	2000	Iopromide	83	≥0.5 mg/dL increase in SCr	CIN in 21% without NAC
Carraro²⁴	1998	Iopromide, iodixanol	64	≥50% increase in SCr	CIN in no subject who received LOCM and in 3% (2/32) with IOCM

Note:—SCr indicates serum creatinine; CIN, contrast-induced nephropathy; LOCM, low osmolar contrast medium; IOCM, iso-osmolal contrast medium; NAC, N-Acetylcystein.