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Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

Elmståhl, Barbara LU ; Nyman, Ulf ; Leander, Peter LU ; Chai, Chun-Ming LU ; Golman, Klaes LU ; Björk, Jonas LU and Almén, Torsten LU (2006) In European Radiology 16(12). p.2712-2720
Abstract
A study was undertaken of the role of osmotoxicity in gadolinium (Gd) and iodine contrast media (CM) nephrotoxicity in ischemic porcine kidneys. Test solutions: mannitol iso-osmotic to 0.5 M: gadopentetate (1.96 Osm/kg H2O), 0.5 M: gadodiamide (0.78 Osm/kg H2O) and 0.5 M: iohexol (190 mg I/ml, 0.42 Osm/kg H2O). Each solution was injected [3 ml/kg body weight (BW)] into the balloon-occluded (10 min) renal artery of eight left-sided nephrectomized pigs. The plasma half-life of a glomerular filtration rate (GFR) marker was used to compare their effects on GFR 1-3 h post-injection. The median half-lives of the GFR marker after injection of gadopentetate (1,730 min) and mannitol 1.96 Osm/kg H2O (2,782 min) did not differ statistically (P =... (More)
A study was undertaken of the role of osmotoxicity in gadolinium (Gd) and iodine contrast media (CM) nephrotoxicity in ischemic porcine kidneys. Test solutions: mannitol iso-osmotic to 0.5 M: gadopentetate (1.96 Osm/kg H2O), 0.5 M: gadodiamide (0.78 Osm/kg H2O) and 0.5 M: iohexol (190 mg I/ml, 0.42 Osm/kg H2O). Each solution was injected [3 ml/kg body weight (BW)] into the balloon-occluded (10 min) renal artery of eight left-sided nephrectomized pigs. The plasma half-life of a glomerular filtration rate (GFR) marker was used to compare their effects on GFR 1-3 h post-injection. The median half-lives of the GFR marker after injection of gadopentetate (1,730 min) and mannitol 1.96 Osm/kg H2O (2,782 min) did not differ statistically (P = 0.28), but were significantly longer than after all other solutions (P < 0.001). There was no significant difference (P = 0.06) between gadodiamide (218 min) and mannitol 0.82 Osm/kg H2O (169 min), while there was (P = 0.03) between iohexol (181 min) and mannitol 0.43 Osm/kg H2O (148 min). The difference between gadodiamide and iohexol was significant (P = 0.01). Reduction in GFR, as a marker of nephrotoxicity, induced by gadopentetate correlated with its high osmolality, while the effect of gadodiamide and iohexol may include chemotoxicity. Iohexol molecules were less nephrotoxic than the Gd-CM molecules and contain three-times the number of attenuating atoms per molecule. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Radiology
volume
16
issue
12
pages
2712 - 2720
publisher
Springer
external identifiers
  • wos:000242324000010
  • scopus:33847730050
  • pmid:16896701
ISSN
0938-7994
DOI
10.1007/s00330-006-0357-4
language
English
LU publication?
yes
id
42daf59e-9d81-41b9-bb67-869749f641f6 (old id 160184)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16896701&dopt=Abstract
date added to LUP
2016-04-01 12:17:31
date last changed
2021-09-15 02:37:32
@article{42daf59e-9d81-41b9-bb67-869749f641f6,
  abstract     = {A study was undertaken of the role of osmotoxicity in gadolinium (Gd) and iodine contrast media (CM) nephrotoxicity in ischemic porcine kidneys. Test solutions: mannitol iso-osmotic to 0.5 M: gadopentetate (1.96 Osm/kg H2O), 0.5 M: gadodiamide (0.78 Osm/kg H2O) and 0.5 M: iohexol (190 mg I/ml, 0.42 Osm/kg H2O). Each solution was injected [3 ml/kg body weight (BW)] into the balloon-occluded (10 min) renal artery of eight left-sided nephrectomized pigs. The plasma half-life of a glomerular filtration rate (GFR) marker was used to compare their effects on GFR 1-3 h post-injection. The median half-lives of the GFR marker after injection of gadopentetate (1,730 min) and mannitol 1.96 Osm/kg H2O (2,782 min) did not differ statistically (P = 0.28), but were significantly longer than after all other solutions (P &lt; 0.001). There was no significant difference (P = 0.06) between gadodiamide (218 min) and mannitol 0.82 Osm/kg H2O (169 min), while there was (P = 0.03) between iohexol (181 min) and mannitol 0.43 Osm/kg H2O (148 min). The difference between gadodiamide and iohexol was significant (P = 0.01). Reduction in GFR, as a marker of nephrotoxicity, induced by gadopentetate correlated with its high osmolality, while the effect of gadodiamide and iohexol may include chemotoxicity. Iohexol molecules were less nephrotoxic than the Gd-CM molecules and contain three-times the number of attenuating atoms per molecule.},
  author       = {Elmståhl, Barbara and Nyman, Ulf and Leander, Peter and Chai, Chun-Ming and Golman, Klaes and Björk, Jonas and Almén, Torsten},
  issn         = {0938-7994},
  language     = {eng},
  number       = {12},
  pages        = {2712--2720},
  publisher    = {Springer},
  series       = {European Radiology},
  title        = {Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections},
  url          = {https://lup.lub.lu.se/search/files/2862967/625548.pdf},
  doi          = {10.1007/s00330-006-0357-4},
  volume       = {16},
  year         = {2006},
}