Kidney Int. 2006;70:1811-1817
A large Swedish study of patients undergoing coronary procedures shows that renal failure is more likely to develop with the use of an iso-osmolar rather than low-osmolar contrast media.
Investigators at the University of Uppsala studied 57,925 patients undergoing coronary angiography or percutaneous coronary interventions at 23 hospitals. Of these, 45,485 received the iso-osmolar contrast medium iodixanol and 12,440 received the low-osmolar contrast medium ioxaglate.
The incidence of clinically significant renal failure within three months of receiving contrast me-dia was 1.7% for the iodixanol recipients versus 0.8% for ioxaglate-treated patients, the team reported. Hospitals that switched from ioxaglate to iodixanol had a doubling in clinically significant renal failure after cardiac procedures, according to the research-ers. Among diabetic patients, who are at increased risk for renal failure, ioxaglate was associated with a 41% lower risk of clinically significant renal failure than iodixanol. Additionally, among patients who previously had experienced renal failure, those treated with ioxaglate had a 46% lower risk of renal failure after their cardiac procedure than iodixanol recipients.