To determine the risk of nephrotoxicity induced by the infusion of radiographic contrast material, we undertook a prospective study of consecutive patients undergoing radiographic procedures with intravascular contrast material. There were three study groups: patients with diabetes mellitus and normal renal function (n = 85), patients with preexisting renal insufficiency (serum creatinine level, greater than or equal to 150 mumol per liter) without diabetes (n = 101), and patients with both diabetes and renal insufficiency (n = 34). The control group consisted of patients undergoing CT scanning or abdominal imaging procedures without the infusion of contrast material who had diabetes mellitus (n = 59), preexisting renal insufficiency (n = 145), or both (n = 64). Clinically important acute renal failure (defined as an increase of greater than 50 percent in the serum creatinine level) attributable to the contrast material did not occur in nondiabetic patients with preexisting renal insufficiency or in diabetics with normal renal function. The incidence of clinically important contrast-induced renal failure among the diabetic patients with preexisting renal insufficiency was 8.8 percent (95 percent confidence interval, 1.9 to 23.7 percent), as compared with 1.6 percent for the controls. The incidence of acute renal insufficiency, more broadly defined as an increase of greater than 25 percent in the serum creatinine level after the infusion of contrast material, was 11.8 percent among all patients with preexisting renal insufficiency. After the exclusion of patients whose acute renal insufficiency could be attributed to other causes, the incidence was 7.0 percent (95 percent confidence interval, 3.2 to 12.8 percent), as compared with 1.5 percent in the control group. The risk of acute renal insufficiency attributable to the contrast material was therefore 5.5 percent, and the relative risk associated with the infusion of contrast material was 4.7. These rates were similar whether the osmolarity of the contrast material was high or low. We conclude that there is little risk of clinically important nephrotoxicity attributable to contrast material for patients with diabetes and normal renal function or for nondiabetic patients with preexisting renal insufficiency. The risk for those with both diabetes and preexisting renal insufficiency is about 9 percent, which is lower than previously reported.
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Division of Nephrology, Health Sciences Centre, Memorial University, St. John's, Canada.
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[Abstract][Full Text]
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[Abstract][Full Text]
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[Abstract][Full Text]
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14: 2178-2187
[Full Text]
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23: 39-46
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[Abstract][Full Text]
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[Abstract][Full Text]
Sandler, C. M.
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[Full Text]
Curhan, G. C.
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289: 606-608
[Full Text]
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(2002). Acetylcysteine protects against acute renal damage in patients with abnormal renal function undergoing a coronary procedure. J Am Coll Cardiol
40: 1383-1388
[Abstract][Full Text]
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179: 1023-1028
[Abstract][Full Text]
Chamsuddin, A. A., Kowalik, K. J., Bjarnason, H., Dietz, C. A., Rosenberg, M. S., Gomes, M. D., McDermott, C. M., Hunter, D. W.
(2002). Using a Dopamine Type IA Receptor Agonist in High-Risk Patients to Ameliorate Contrast-Associated Nephropathy. Am. J. Roentgenol.
179: 591-596
[Abstract][Full Text]
Briguori, C., Manganelli, F., Scarpato, P., Elia, P. P., Golia, B., Riviezzo, G., Lepore, S., Librera, M., Villari, B., Colombo, A., Ricciardelli, B.
(2002). Acetylcysteine and contrast agent-associated nephrotoxicity. J Am Coll Cardiol
40: 298-303
[Abstract][Full Text]
Huber, W., Ilgmann, K., Page, M., Hennig, M., Schweigart, U., Jeschke, B., Lutilsky, L., Weiss, W., Salmhofer, H., Classen, M.
(2002). Effect of Theophylline on Contrast Material-induced Nephropathy in Patients with Chronic Renal Insufficiency: Controlled, Randomized, Double-blinded Study. Radiology
223: 772-779
[Abstract][Full Text]
Rihal, C. S., Textor, S. C., Grill, D. E., Berger, P. B., Ting, H. H., Best, P. J., Singh, M., Bell, M. R., Barsness, G. W., Mathew, V., Garratt, K. N., Holmes, D. R. Jr
(2002). Incidence and Prognostic Importance of Acute Renal Failure After Percutaneous Coronary Intervention. Circulation
105: 2259-2264
[Abstract][Full Text]
Rieger, J., Sitter, T., Toepfer, M., Linsenmaier, U., Pfeifer, K. J., Schiffl, H.
(2002). Gadolinium as an alternative contrast agent for diagnostic and interventional angiographic procedures in patients with impaired renal function. Nephrol Dial Transplant
17: 824-828
[Abstract][Full Text]
Spinosa, D. J., Kaufmann, J. A., Hartwell, G. D.
(2002). Gadolinium Chelates in Angiography and Interventional Radiology: A Useful Alternative to Iodinated Contrast Media for Angiography. Radiology
223: 319-325
[Abstract][Full Text]
Spinosa, D. J., Kaufmann, J. A., Hartwell, G. D.
(2002). Commentary on the Viewpoint of Nyman et al. Radiology
223: 328-329
[Full Text]
Mueller, C., Buerkle, G., Buettner, H. J., Petersen, J., Perruchoud, A. P., Eriksson, U., Marsch, S., Roskamm, H.
(2002). Prevention of Contrast Media-Associated Nephropathy: Randomized Comparison of 2 Hydration Regimens in 1620 Patients Undergoing Coronary Angioplasty. Arch Intern Med
162: 329-336
[Abstract][Full Text]
Bazari, H., Mauiyyedi, S.
(2002). Case 4-2002 - A 75-Year-Old Man with Acute Renal Failure Five Months after Cystoprostatectomy and Urethrectomy for Carcinoma. NEJM
346: 353-360
[Full Text]
Kessel, D O, Robertson, I, Patel, J V, Simpson, S, Taylor, E J
(2001). Angiographic strategies when iodinated contrast medium is undesirable. Imaging
13: 349-356
[Abstract][Full Text]
Schindler, R., Stahl, C., Venz, S., Ludat, K., Krause, W., Frei, U.
(2001). Removal of contrast media by different extracorporeal treatments. Nephrol Dial Transplant
16: 1471-1474
[Abstract][Full Text]
Bassilios, N., Mercadal, L., Deray, G.
(2001). Immunoglobulin as a risk factor for contrast media nephrotoxicity. Nephrol Dial Transplant
16: 1513-1514
[Full Text]
BAKER, C S R, BAKER, L R I
(2001). Prevention of contrast nephropathy after cardiac catheterisation. Heart
85: 361-362
[Full Text]
Tombach, B., Bremer, C., Reimer, P., Kisters, K., Schaefer, R. M., Geens, V., Heindel, W.
(2001). Renal Tolerance of a Neutral Gadolinium Chelate (gadobutrol) in Patients with Chronic Renal Failure: Results of a Randomized Study. Radiology
218: 651-657
[Abstract][Full Text]
Huber, A., Heuck, A., Baur, A., Helmberger, T., Waggershauser, T., Billing, A., Heiss, M., Petsch, R., Reiser, M.
(2000). Dynamic Contrast-Enhanced MR Angiography from the Distal Aorta to the Ankle Joint with a Step-by-Step Technique. Am. J. Roentgenol.
175: 1291-1298
[Abstract][Full Text]
Dewald, C. L., Jensen, C. C., Park, Y. H., Hanks, S. E., Harrell, D. S., Peters, G. L., Katz, M. D.
(2000). Vena Cavography with CO2 versus with Iodinated Contrast Material for Inferior Vena Cava Filter Placement: A Prospective Evaluation. Radiology
216: 752-757
[Abstract][Full Text]
Tippins, R. B., Torres, W. E., Baumgartner, B. R., Baumgarten, D. A.
(2000). Are Screening Serum Creatinine Levels Necessary prior to Outpatient CT Examinations?. Radiology
216: 481-484
[Abstract][Full Text]
Tepel, M., van der Giet, M., Schwarzfeld, C., Laufer, U., Liermann, D., Zidek, W.
(2000). Prevention of Radiographic-Contrast-Agent-Induced Reductions in Renal Function by Acetylcysteine. NEJM
343: 180-184
[Abstract][Full Text]
Koch, J.-A., Plum, J., Grabensee, B., Modder, U.
(2000). Prostaglandin E1: a new agent for the prevention of renal dysfunction in high risk patients caused by radiocontrast media?. Nephrol Dial Transplant
15: 43-49
[Abstract][Full Text]
MURPHY, S. W., BARRETT, B. J., PARFREY, P. S.
(2000). Contrast Nephropathy. J. Am. Soc. Nephrol.
11: 177-182
[Full Text]
Gare, M., Haviv, Y. S., Ben-Yehuda, A., Rubinger, D., Bdolah-Abram, T., Fuchs, S., Gat, O., Popovtzer, M. M., Gotsman, M. S., Mosseri, M.
(1999). The renal effect of low-dose dopamine in high-risk patients undergoing coronary angiography. J Am Coll Cardiol
34: 1682-1688
[Abstract][Full Text]
Deray, G.
(1999). Nephrotoxicity of contrast media. Nephrol Dial Transplant
14: 2602-2606
[Full Text]
Scanlon, P. J., Faxon, D. P., Audet, A.-M., Carabello, B., Dehmer, G. J., Eagle, K. A., Legako, R. D., Leon, D. F., Murray, J. A., Nissen, S. E., Pepine, C. J., Watson, R. M., Ritchie, J. L., Gibbons, R. J., Cheitlin, M. D., Eagle, K. A., Gardner, T. J., Garson, A. Jr, Russell, R. O. Jr, Ryan, T. J., Smith, S. C. Jr
(1999). ACC/AHA guidelines for coronary angiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol
33: 1756-1824
[Full Text]
Stevens, M. A., McCullough, P. A., Tobin, K. J., Speck, J. P., Westveer, D. C., Guido-Allen, D. A., Timmis, G. C., O'Neill, W. W.
(1999). A prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy: Results of the P.R.I.N.C.E. study. J Am Coll Cardiol
33: 403-411
[Abstract][Full Text]
Rahman, M., Smith, M. C.
(1998). Chronic Renal Insufficiency: A Diagnostic and Therapeutic Approach. Arch Intern Med
158: 1743-1752
[Abstract][Full Text]
Barrett, B. J., Parfrey, P. S.
(1994). Prevention of Nephrotoxicity Induced by Radiocontrast Agents. NEJM
331: 1449-1450
[Full Text]
Redman, H. C., Miller, G. L.
(1990). Water-Soluble Radiographic Contrast Media: Ionic vs. Nonionic. PERSPECT VASC SURG ENDOVASC THER
3: 45-55
Bettmann, M. A.
(1990). Expert Commentary. PERSPECT VASC SURG ENDOVASC THER
3: 56-58
(1989). CONTRAST-DYE NEPHROPATHY: THE RISKS ARE LOWER THAN EXPECTED. JWatch General
1989: 7-7
[Full Text]
Krupski, W. C.
(1989). Expert Commentary. PERSPECT VASC SURG ENDOVASC THER
2: 15-16
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