Renal failure in 57 925 patients undergoing coronary procedures using iso-osmolar or low-osmolar contrast media.
نویسندگان
چکیده
We compared the Swedish Coronary Angiography and Angioplasty Registry with the Swedish 'Hospital Discharge Register' to assess contrast media (CM)-induced renal failure. Hospitals used only one type CM. From 2000 to 2003, iodixanol (iso-osmolar) was used in 45 485 patients, ioxaglate (low osmolar) in 12 440 subjects. To include the earlier used CM iohexol (low osmolar), analysis extended back to 1990 (86 334 patients). Incidence of clinically significant renal failure was greatest for patients receiving the iso-osmolar CM iodixanol (1.7%). Ioxaglate-treated patients had a significantly lower renal failure incidence (0.8%, P<0.001). The odds ratio for iodixanol-treated patients was significantly higher than for ioxaglate (1 vs 0.48, P<0.001). In subsets of either diabetic patients or patients with previous renal failure, odds ratios for renal failure remained greater in the iodixanol groups (P<0.01). Hospitals switching CM to iodixanol experienced a doubling in clinically significant renal failure after cardiac procedures. Dialysis was required in 0.2% of patients receiving iodixanol, which was significantly higher (P<0.01) than for ioxaglate-treated patients (0.1%). Iohexol-treated patients had a similar low risk for developing clinically significant renal failure (0.9%) as ioxaglate. In conclusion, risk of developing renal failure and required dialysis after coronary procedures is higher when patients received iodixanol than ioxaglate or iohexol.
منابع مشابه
Contrast media induced nephropathy: CONTRAST There is an ongoing controversy on the impact of iso- osmolar contrast agents on contrast media induced nephropathy (CIN). The COntrast Media and Neph- roToxicity Following Coronary Revascularization by AngioplaSTy
There is an ongoing controversy on the impact of isoosmolar contrast agents on contrast media induced nephropathy (CIN). The COntrast Media and NephroToxicity Following Coronary Revascularization by AngioplaSTy (CONTRAST) randomized 324 patients with impaired renal function undergoing PCI to receive either the iso-osmolar contrast medium iodixanol 320 (Visipaque ) or the low-osmolar contrast me...
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Nephrotoxicity of iodixanol versus ioversol in patients with chronic kidney disease: the Visipaque Angiography/Interventions with Laboratory Outcomes in Renal Insufficiency (VALOR) Trial.
BACKGROUND Iso-osmolar contrast medium iodixanol has been reported to be less nephrotoxic than selected low-osmolar contrast media (LOCM) in chronic kidney disease (CKD) patients with diabetes mellitus. This study compared the nephrotoxicity of iodixanol and the LOCM ioversol in CKD patients undergoing coronary angiography. METHODS This is a prospective double-blind trial in 337 patients with...
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ورودعنوان ژورنال:
- Kidney international
دوره 70 10 شماره
صفحات -
تاریخ انتشار 2006