News | July 30, 2009

New Data on Contrast Media, Kidney Damage May Impact Guidelines

July 30, 2009 - The iso-omolar contrast medium iodixanol does not yield lower rates of contrast-induced acute kidney injury (CI-AKI) than low-osmolar contrast media (LOCM), according to a meta-analysis published in the July 2009 issue of JACC: Cardiovascular Interventions.

Could these findings change current ACC/AHA guidelines, which give a class IA recommendation for iso-osmolar contrast media in patients with chronic kidney disease undergoing coronary angiography?

In the study, a team of researchers at the University of Michigan Medical School led by Hitinder Gurm, M.D., analyzed pooled data from 16 trials conducted between 1980 and 2008 that included 2,763 subjects. The studies consistently ascertained renal function data from patients randomized to either LOCM or iodixanol. The primary endpoint for the meta-analysis was the incidence of CI-AKI as defined by each individual study protocol.

Kidney injury occurred in 128 of 1,379 (9.3%) patients who received iodixanol vs. 158 of 1,375 (11.5%) patients who received LOCM. There was a trend toward a reduced relative risk of CI-AKI with iodixanol compared to LOCM as a whole, although the difference was not significant. After looking at individual types of contrast media, iodixanol did offer a significant advantage in some cases (table 1). Because only 1 study used iomeprol, an analysis was not conducted for this agent. Further, the risk of mortality and need for hemodialysis were similar between the iodixanol and LOCM groups.

This is contrary to earlier research suggesting iodixanol caused less kidney damage than LOCM. This conclusion led to the current ACC/AHA guidelines recommending iso-osmolar contrast media in NSTE ACS patients with chronic kidney disease undergoing angiography.

In light of the new data, the ACC/AHA guidelines may change, and subsequently drive the adoption of less expensive imaging alternatives that are just as effective as the more costly iodixanol, such as Bracco’s iopamidol or Isovue.

For more information: www.bracco.com

Related Content

Study Finds No Evidence that Gadolinium Causes Neurologic Harm

MR images through, A, C, E, basal ganglia and, B, D, F, posterior fossa at level of dentate nucleus. Images are shown for, A, B, control group patient 4, and the, C, D, first and, E, F, last examinations performed in contrast group patient 13. Regions of interest used in quantification of signal intensity are shown as dashed lines for globus pallidus (green), thalamus (blue), dentate nucleus (yellow), and pons (red).

News | Contrast Media | January 11, 2018
January 11, 2018 — There is no evidence that accumulation in the brain of the element gadolinium speeds cognitive dec
Male Triathletes May Be Putting Their Heart Health at Risk
News | Cardiac Imaging | January 09, 2018
Competitive male triathletes face a higher risk of a potentially harmful heart condition called myocardial fibrosis,...
Videos | Magnetic Resonance Imaging (MRI) | December 19, 2017
Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pitt
The FDA issued new warnings on MRI gadolinium contrast agents. (GBCAs)

The FDA issued new warnings on MRI gadolinium contrast agents. 

Feature | Magnetic Resonance Imaging (MRI) | December 19, 2017
The U.S.
Brainlab Contrast Clearance Analysis Software Receives FDA 510(k) Clearance
Technology | Contrast Media | December 12, 2017
Brainlab announced U.S. Food and Drug Administration (FDA) clearance of its Contrast Clearance Analysis methodology,...
Sectra Offers Gadolinium Tracking Functionality in DoseTrack Software
Technology | Contrast Media | December 11, 2017
December 11, 2017 — Sectra recently announced the global introduction of gadolinium tracking in its dose monitoring s
Videos | Magnetic Resonance Imaging (MRI) | December 07, 2017
Max Wintermark, M.D., professor of radiology and chief of neuroradiology, Stanford Hospital and Clinics, discussed MR
Guerbet to Participate in French Interventional Radiology Conference
News | Contrast Media | October 10, 2017
Guerbet announced it will be taking part in the 65th edition of the Journées Francophones de Radiologie (JFR) that will...
Trends in contrast media used in magnetic resonance imaging and computed tomography

Image courtesy of Bayer

Feature | Contrast Media | October 04, 2017 | By Dave Fornell
Over the past decade, several clinical studies have shown gadolinium-based magnetic resonance imaging (MRI) contrast...
FDA Committee Votes to Expand Warning Labels on Gadolinium-Based Contrast Agents
News | Contrast Media | September 12, 2017
The U.S. Food and Drug Administration’s (FDA) Medical Imaging Drugs Advisory Committee (MIDAC) voted overwhelmingly...
Overlay Init