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 languageEnglish
Pages (from-to)2572-2580
Number of pages9
JournalJournal of Cellular Physiology
Volume233
Issue number3
DOIs
Publication statusPublished - 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

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