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Kidney Injury From Contrast Media Appears Low: Presented at ACC By Ed Susman ATLANTA -- March 18, 2010 -- The risk of suffering acute kidney injury from exposure to iodinated contrast media appears to be very low, with few differences noted between the 3 most commonly used low-osmolar formulations, according to a study here at the 59th Annual Scientific Sessions of the American College of Cardiology (ACC). James Min, MD, Weill Cornell Medical College, New York, New York, noted that haemodialysis risk did not differ between iopamidol and iohexol, but the risk of haemodialysis appeared to be increased with ioversol compared with iohexol. He cautioned that the conclusion was based on a retrospective analysis that did not include access to patient hospital charts. “The data on contrast-induced acute kidney injury rates among the different iodinated contrast media remain the basis for clinical decisions when choosing a contrast media,” Dr. Min said on March 15. “However, the data on contrast-induced acute kidney injury has primarily focused on comparing iso-osmolar versus low-osmolar iodinated contrast media.” He added, “To date, head-to-head trials comparing rates among the different low-osmolar iodinated contrast media are lacking, and incidence of hard outcomes including need for haemodialysis and in-hospital mortality is currently unknown.” The researchers analysed in-patient medical data of >200,000 patients from the Premier Perspective database from January 1, 2007, through December 31, 2008. The study included 3 cohorts of patients undergoing cardiac catheterisation procedures: those receiving iohexol, those receiving iopamidol, and those receiving ioversol. The database includes data from more than 700 hospitals. In the multivariate logistic regression analysis, researchers controlled for age, sex, race, admission type, severity of illness, major comorbidities, urban population, teaching hospital, hospital bed size, and geographic region. The study found that haemodialysis rates were low after exposure to any low-osmolar iodinated contrast media agent. The rate was 0.8% with iohexol versus 1.0% with iopamidol versus 1.0% with ioversol. Risk of haemodialysis did not differ between iopamidol and iohexol, although ioversol demonstrated increased risk of haemodialysis compared with iohexol (odds ratio 1.28, 95% confidence interval, 1.11-1.45). “No significant differences in in-hospital mortality existed for use of any low-osmolar iodinated contrast media agent,” Dr. Min said. Future prospective studies with direct comparison of low-osmolar iodinated contrast media agents for risk of haemodialysis should be performed. Funding for this study was provided by GE Healthcare. [Presentation title: In-Hospital Hemodialysis and Mortality Rates in Individuals Undergoing Invasive Cardiac Catheterization Procedures With Low Osmolar Contrast Agents: A Multicenter Study of 207,826 Patients. Abstract 1192-155] E-mail this page to a friend or colleague! To print, use this version