USE OF HIGH-DOSE GADOLINIUM AS CONTRAST MEDIA TO AVOID RADIOCONTRAST MEDIA-INDUCED NEPHROPATHY

SUMMARY Patients at risk for radiocontrast media‐induced nephropathy (RCIN) with suspected peripheral vascular disease were evaluated with high‐dose (0.4 mmol/kg) gadolinium‐based (Gd) contrast angiography (AG). The patients who were considered susceptible to RCIN were defined by having one or more...

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Published in:Journal of renal care 2009-03, Vol.35 (1), p.11-15
Main Authors: Ruangkanchanasetr, Prajej, Rojanamethin, Suchada, Ruamthanthong, Anuchit, Chaiprasert, Amnart, Supaporn, Thanom
Format: Article
Language:English
Subjects:
Acute Kidney Injury - chemically induced
Acute Kidney Injury - prevention & control
Aged
Aged, 80 and over
Angiography, Digital Subtraction - methods
Contrast Media - adverse effects
Disease Susceptibility
Female
Gadolinium
Humans
Male
Middle Aged
Nephropathy
Radiocontrast media
Radioisotopes
Risk Assessment
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Summary:SUMMARY Patients at risk for radiocontrast media‐induced nephropathy (RCIN) with suspected peripheral vascular disease were evaluated with high‐dose (0.4 mmol/kg) gadolinium‐based (Gd) contrast angiography (AG). The patients who were considered susceptible to RCIN were defined by having one or more of the following: (1) pre‐existing serum creatinine (SCr) >124 μmol/l, (2) diabetes mellitus and (3) age >60 years. An increase in SCr ≥ 44 μmol/l or ≥ 25% of baseline was considered significant. Ten patients underwent peripheral AG using a high dose of Gd without any adverse reaction. The mean age was 67.8 years. Nine (90%) patients were diabetic. The quality of these images was satisfactory for diagnosis in eight out of 10 patients. None of these patients had significant change in SCr. The mean SCr (±SD) before, at 48 hours and at 72 hours after AG were 182 ± 97, 177 ± 99 and 177 ± 98 μmol/l, respectively. Based on this limited study, Gd is a promising agent for peripheral angiographic study. In patients at risk for RCIN, the high dose of Gd appears to be safe without obvious nephrotoxicity.
ISSN:1755-6678
1755-6686
DOI:10.1111/j.1755-6686.2009.00085.x