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NDT Advance Access published online on November 25, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn638
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Assessment of renal vasoconstriction in vivo after intra-arterial administration of the isosmotic contrast medium iodixanol compared to the low-osmotic contrast medium iopamidol

Marcus Treitl1, Harald Rupprecht2, Stefan Wirth1, Markus Korner1, Maximilian Reiser1 and Johannes Rieger1

1 Department for Clinical Radiology, Clinical Center of the Ludwig-Maximilians- University of Munich 2 Department 5 of Internal Medicine, Nephrology, Clinical Center of Bayreuth, Germany

Correspondence and offprint requests to: Marcus Treitl, Department for Clinical Radiology, University of Munich, Pettenkoferstr. 8a, 80336 Munich, Germany. Tel: +49-89-5160-9280; Fax: +49-89-5160-9282; E-mail: marcus.treitl{at}med.uni-muenchen.de



  Abstract

Background. Low-osmotic contrast media (LOCM) such as iopamidol are known to increase the renal resistance index (RRI). The aim of our study was to evaluate in vivo the different effects of intra-arterial administration of LOCM in comparison to isosmotic contrast medium (IOCM) such as iodixanol on the human RRI.

Methods. Twenty patients (16 males, 4 females; 66 years on average) with normal renal function (mean creatinine 1.0 mg/dl) had digital subtraction angiography (DSA) of the abdominal and lower-limb arteries. Ten patients received LOCM, and 10 patients IOCM (150 ml on average, 20 ml/s). The RRI was assessed by an experienced nephrologist with duplex ultrasound from 15 min before until 30 min after the first injection with delays of 1–5 min. The basic value of the RRI and differential RRI were calculated.

Results. The basic value of the RRI was 0.69 in the LOCM group and 0.71 in the IOCM group. After LOCM a significant increase of the RRI to 0.73 on average (P ≤ 0.001) 2 min after the first injection was found, whereas IOCM did not result in a significant change of the RRI (RRI remained 0.71 on average, P ≥ 0.1). In the LOCM group, the RRI returned to the basic value after 30 min (±2.3 min).

Conclusions. Intra-arterial administration of IOCM had no influence on renal vascular resistance as expressed by the RRI, unlike LOCM, which induced a highly significant increase of the RRI for up to 30 min.

Keywords: colour-coded duplex sonography; contrast media; contrast media-induced nephropathy; digital subtraction angiography; renal resistance index

Received for publication: 9. 1.08
Accepted in revised form: 22.10.08


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