Iodixanol Versus Low-Osmolar Contrast Media for Prevention of Contrast Induced Nephropathy
Open Access
- 1 August 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Cardiovascular Interventions
- Vol. 3 (4), 351-358
- https://doi.org/10.1161/circinterventions.109.917070
Abstract
Background—: Contrast-induced nephropathy (CIN) is associated with significant morbidity and mortality. The objective of our meta-analysis was to assess the efficacy of iodixanol compared with low-osmolar contrast media (LOCM) for prevention of CIN. Methods and Results—: We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and internet sources of cardiology trial results for individual and relevant reviews of randomized, controlled trials, for the terms contrast media, contrast nephropathy, renal failure, iodixanol, Visipaque, and low-osmolar contrast media. All studies reported an incidence rate of CIN for each study group; there was no restriction on the definition of CIN. There were no restrictions on journal type or patient population. Overall, 36 trials were identified for analysis of aggregated summary data on 7166 patients; 3672 patients received iodixanol and 3494 patients received LOCM. Overall, iodixanol showed no statistically significant reduction in CIN incidence below that observed with heterogeneous comparator agents ( P =0.11). Analysis of patient subgroups revealed that there was a significant benefit of iodixanol when compared with iohexol alone (odds ratio, 0.25; 95% confidence interval, 0.11 to 0.55; P <0.001) but not when compared with LOCM other than iohexol or with other ionic dimers or among patients receiving intra-arterial contrast injections or among patients undergoing coronary angiography with or without percutaneous intervention. Conclusions—: Analysis of aggregated summary data from multiple randomized, controlled trials of iodixanol against diverse LOCMs for heterogeneous procedures and definitions of CIN show an iodixanol-associated reduction that is suggestive but statistically nonsignificant.Keywords
This publication has 54 references indexed in Scilit:
- Choice of Contrast Medium in Patients With Impaired Renal Function Undergoing Percutaneous Coronary InterventionCirculation: Cardiovascular Interventions, 2009
- The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and ElaborationPLoS Medicine, 2009
- The Relative Renal Safety of Iodixanol Compared With Low-Osmolar Contrast MediaКАРДИОЛОГИЯ УЗБЕКИСТАНА, 2009
- Ionic Low-Osmolar Versus Nonionic Iso-Osmolar Contrast Media to Obviate Worsening Nephropathy After Angioplasty in Chronic Renal Failure Patients: The ICON (Ionic versus non-ionic Contrast to Obviate worsening Nephropathy after angioplasty in chronic renal failure patients) StudyJACC: Cardiovascular Interventions, 2009
- Ultra-Low Contrast Volumes Reduce Rates of Contrast-Induced Nephropathy in Patients With Chronic Kidney Disease Undergoing Coronary AngiographyJournal of the American College of Cardiology, 2007
- Effects of non-ionic iodinated contrast media on patient heart rate and pressures during intra-cardiac or intra-arterial injectionInternational Journal of Cardiology, 2007
- Nephrotoxicity of iso-osmolar versus low-osmolar contrast media is equal in low risk patientsClinical Nephrology, 2006
- Contrast Medium UseThe American Journal of Cardiology, 2006
- Iodixanol, a new isosmotic nonionic contrast agent compared with iohexol in cardiac angiographyThe American Journal of Cardiology, 1994
- Contrast Material-Induced Renal Failure in Patients with Diabetes Mellitus, Renal Insufficiency, or BothNew England Journal of Medicine, 1989