Nephrotoxicity after Renal Angiography Using Iodine and Gadolinium Contrast Mediain Pigs with Renal Damage

Abstract

Iodine contrast medium (I-CM) induced nephrotoxicity is recognized for many years and is especially frequent in patients with pre-existing renal insufficiency alone or combined with diabetes mellitus. The use of non-ionic low osmolar contrast media (LOCM) has reduced the risk of renal injury after X-ray arteriography in patients with renal impairment (1). The importance of nephrotoxicity may increase in the future, due to an anticipated higher number of examinations of elderly subjects, who often have impaired renal function. Furthermore, interventional radiology uses large doses of contrast media (CM). These risk factors make it necessary to adopt some strategies to overcome the problems with nephrotoxicity associated with CM administration in patients with renal damage, for instance the use of non-ionic LOCM (1) and adequate hydration of the patients (2,3). Another strategy, to which we oppose, is the exchange of I-CM to gadolinium CM (Gd-CM) (4–9).