NEW YORK (Reuters Health) – In patients with impaired renal function, the type of nonionic contrast agent used for coronary angiography seems to make little difference to the subsequent rate of contrast-induced nephrotoxicity, a Korean team has shown.

Dr. Tae-Jin Youn, at Seoul National University, and colleagues point out in the American Journal of Cardiology online May 5 that comparisons of iso-osmolar and low-osmolar contrast media have been inconclusive, with contradictory results reported.

For the current study, the researchers randomized 429 patients with creatinine clearance less than 60 mL/min to receive either the iso-osmolar contrast medium iodixanol or the low-osmolar contrast medium iopromide during coronary angiography.

The primary endpoint was the development of contrast-induced nephrotoxicity, defined as an increase in serum creatinine of 0.5 mg/dL or more, or an increase of at least 25% above baseline. The incidence was not significantly different between the iodixanol and iopromide arms: 10.7% vs 7.8%, respectively (p=0.394), the team reports.

Furthermore, they observed no statistically significant differences in secondary endpoints, including rates of increases in serum creatinine >0.5 mg/dL or >1.0 mg/dL, and the peak increase in serum creatinine.

“In conclusion,” Dr. Youn and colleagues write, “the incidences of CIN (contrast-induced nephrotoxicity) after coronary angiography did not significantly differ between the iodixanol and iopromide groups in patients with impaired renal function.”

Reference:
Comparison of Contrast-Induced Nephrotoxicity of Iodixanol and Iopromide in Patients With Renal Insufficiency Undergoing Coronary Angiography
Am J Cardiol 2011.