| Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections? | |
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MedLine Citation:
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PMID: 22307815 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Ulf Nyman; Torsten Almén; Bo Jacobsson; Peter Aspelin |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-4 |
Journal Detail:
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Title: European radiology Volume: - ISSN: 1432-1084 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9114774 Medline TA: Eur Radiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Diagnostic Radiology, University of Lund, Lasarettet Trelleborg, SE-231 85, Trelleborg, Sweden, ulf.nyman@skane.se. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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