Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?
(2012) In European Radiology 22(6). p.1366-1371- Abstract
- We oppose the opinion that the intra-arterial administration of iodine-based contrast media (CM) appears to pose a greater risk of contrast medium-induced nephropathy (CIN) than intravenous administration since 1) in intra-arterial coronary procedures and most other intra-arterial angiographic examinations, CM injections are also intravenous relative to the kidneys, 2) there is a lack of comparative trials studying the risk of CIN between intra-arterial and intravenous procedures with matched risk factors and CM doses, 3) a bias selection of patients with fewer risk factors may explain the seemingly lower rate of CIN after CT in comparison with coronary interventions, 4) the rate of CIN following intra-arterial coronary procedures may also... (More)
- We oppose the opinion that the intra-arterial administration of iodine-based contrast media (CM) appears to pose a greater risk of contrast medium-induced nephropathy (CIN) than intravenous administration since 1) in intra-arterial coronary procedures and most other intra-arterial angiographic examinations, CM injections are also intravenous relative to the kidneys, 2) there is a lack of comparative trials studying the risk of CIN between intra-arterial and intravenous procedures with matched risk factors and CM doses, 3) a bias selection of patients with fewer risk factors may explain the seemingly lower rate of CIN after CT in comparison with coronary interventions, 4) the rate of CIN following intra-arterial coronary procedures may also be exaggerated owing to other causes of acute kidney failure, such as haemodynamic instability and microembolisation, 5) roughly the same gram-iodine/GFR ratio (≈1:1) as a limit of relatively safe CM doses has preliminarily been found for both intravenous CT and intra-arterial coronary procedures and 6) the substantially higher injected intravenous CM dose rate during CT relative to an intra-arterial coronary procedure might actually pose a higher risk of CIN following CT. Key Points • Most intra-arterial injections of contrast media are intravenous relative to the kidneys.• No evidence that intravenous CM injections should be less nephrotoxic than intra-arterial.• Considerably higher dose rates of CM are used for CT relative to intra-arterial procedures.• Higher dose rates may pose higher nephrotoxic risk for intravenous based CT studies. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2367227
- author
- Nyman, Ulf LU ; Almén, Torsten LU ; Jacobsson, Bo and Aspelin, Peter
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Radiology
- volume
- 22
- issue
- 6
- pages
- 1366 - 1371
- publisher
- Springer
- external identifiers
-
- wos:000303876100027
- pmid:22307815
- scopus:84861526852
- pmid:22307815
- ISSN
- 0938-7994
- DOI
- 10.1007/s00330-011-2371-4
- language
- English
- LU publication?
- yes
- id
- fdfcd91e-47db-44ee-a4c1-92a6e8f78f38 (old id 2367227)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22307815?dopt=Abstract
- date added to LUP
- 2016-04-04 08:56:59
- date last changed
- 2022-05-09 02:57:31
@article{fdfcd91e-47db-44ee-a4c1-92a6e8f78f38,
abstract = {{We oppose the opinion that the intra-arterial administration of iodine-based contrast media (CM) appears to pose a greater risk of contrast medium-induced nephropathy (CIN) than intravenous administration since 1) in intra-arterial coronary procedures and most other intra-arterial angiographic examinations, CM injections are also intravenous relative to the kidneys, 2) there is a lack of comparative trials studying the risk of CIN between intra-arterial and intravenous procedures with matched risk factors and CM doses, 3) a bias selection of patients with fewer risk factors may explain the seemingly lower rate of CIN after CT in comparison with coronary interventions, 4) the rate of CIN following intra-arterial coronary procedures may also be exaggerated owing to other causes of acute kidney failure, such as haemodynamic instability and microembolisation, 5) roughly the same gram-iodine/GFR ratio (≈1:1) as a limit of relatively safe CM doses has preliminarily been found for both intravenous CT and intra-arterial coronary procedures and 6) the substantially higher injected intravenous CM dose rate during CT relative to an intra-arterial coronary procedure might actually pose a higher risk of CIN following CT. Key Points • Most intra-arterial injections of contrast media are intravenous relative to the kidneys.• No evidence that intravenous CM injections should be less nephrotoxic than intra-arterial.• Considerably higher dose rates of CM are used for CT relative to intra-arterial procedures.• Higher dose rates may pose higher nephrotoxic risk for intravenous based CT studies.}},
author = {{Nyman, Ulf and Almén, Torsten and Jacobsson, Bo and Aspelin, Peter}},
issn = {{0938-7994}},
language = {{eng}},
number = {{6}},
pages = {{1366--1371}},
publisher = {{Springer}},
series = {{European Radiology}},
title = {{Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?}},
url = {{http://dx.doi.org/10.1007/s00330-011-2371-4}},
doi = {{10.1007/s00330-011-2371-4}},
volume = {{22}},
year = {{2012}},
}