Abstract
To assess the safety profile of iso-osmolar contrast medium (CM) versus low osmolar CM in cancer patients with an estimated glomerular filtration rate (eGFR) >60 ml/min. In this multicenter, blind trial of patients seeking a chest-abdomen-pelvis contrast enhanced computed tomography (CT) with iodated CM, participants were centrally randomized to iodixanol or iopromide. Contrast induced nephropathy (CIN) at 24 and/or 72 hr were our primary outcomes. We further considered irreversible CIN, average eGFR percentage variation (%Δ), and adverse events (AEs). Overall, 607 patients were enrolled. Among them, 497 eligible patients were randomized to iodixanol (N: 247) or iopromide (N: 250). No differences emerged by descriptive characteristics. Seven and 3 CIN at 24 hr (p = 0.34) and 8 and 2 CIN at 72 hr (p = 0.11) occurred in the iopromide and iodixanol group, respectively. Within the subgroup of individual patients who developed CIN (N: 17), the event rate was higher in the iopromide arm (p = 0.045). No cases of permanent CIN or significant differences in terms of AEs or GFR %Δ were observed. Our results suggest a more favorable safety profile of iodixanol versus iopromide. Adequately sized trials with similar design are warranted to confirm our findings and clarify the underlying biological mechanisms. © 2017 Wiley Periodicals, Inc.
Original language | English |
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Pages (from-to) | 2572-2580 |
Number of pages | 9 |
Journal | Journal of Cellular Physiology |
Volume | 233 |
Issue number | 3 |
DOIs | |
Publication status | Published - 2018 |
Keywords
- cancer patients
- contrast induced nephropathy
- low-osmolar/iso-osmolar contrast medium
- iodixanol
- iopromide
- contrast medium
- iodobenzoic acid derivative
- iohexol
- abdomen
- adult
- aged
- Article
- cancer patient
- clinical assessment
- contrast enhancement
- controlled study
- drug safety
- estimated glomerular filtration rate
- female
- human
- low risk patient
- major clinical study
- male
- multicenter study
- outcome assessment
- pelvis
- priority journal
- randomized controlled trial
- single blind procedure
- thorax
- x-ray computed tomography
- adolescent
- analogs and derivatives
- chemically induced
- clinical trial
- comparative study
- diagnostic imaging
- drug effects
- glomerulus filtration rate
- Italy
- kidney
- kidney disease
- middle aged
- neoplasm
- pathology
- pathophysiology
- patient safety
- predictive value
- risk factor
- time factor
- young adult
- Adolescent
- Adult
- Aged
- Contrast Media
- Female
- Glomerular Filtration Rate
- Humans
- Iohexol
- Kidney
- Kidney Diseases
- Male
- Middle Aged
- Neoplasms
- Patient Safety
- Predictive Value of Tests
- Risk Factors
- Time Factors
- Tomography, X-Ray Computed
- Triiodobenzoic Acids
- Young Adult