Studies supporting renal safety of GBC agentsa
| Reference | Study | Contrast Agent | Dosage (mmol/kg) | Renal Function ([Cr] in mg/dl) | Result |
|---|---|---|---|---|---|
| Niendorf et al. (18), 1993 | Phase III trial, n = 1171 [Cr] at 24 h, subgroup with [Cr] at 5 d | Gadopentetate | 0.10 | [Cr] <1.3, [Cr] >1.3 to 1.4, [Cr] >1.4 | No change in [Cr], Subgroup of patients: GFR 20 to 40: [Cr] ↑ 0.25 GFR <20: [Cr] ↑ 0.25 |
| Arsenault et al. (20), 1996 | Retrospective, n = 136, n = 90 with pre/post [Cr] at 3 d | Gadopentetate | 0.10 | [Cr] >2.0, mean [Cr] 2.5 | No change in [Cr] baseline (2.5) to day 3 (2.3) |
| Prince et al. (21), 1996 | Retrospective, n = 64, [Cr] 2 d pre and 2 d post, CIN ≥0.5 mg/dl | Gadopentetate, gadodiamide, gadoteridol | 0.20 to 0.40 | [Cr] >1.5, mean [Cr] 2.0 ± 1.4 | CIN: RC- 11/64 (17%) Gado- 0/64 (0%) |
| Swan et al. (16), 1999 | Prospective, double-blind random, 32 patients (2:1), CIN >0.5 mg/dl | Gabobenate dimeglumine | 0.20 | CrCl 10 to 30, CrCl 31 to 60, 24-h urine | No CIN |
| Hammer et al. (22), 1999 | n = 31, 34 DSAs, mean age 53.1, CIN >0.5 mg/dl | Gadopentetate | 0.40 | [Cr] >1.5 | CIN: 1/34 (3%) |
| Spinosa et al. (23), 2000 | n = 40, LE angiograms, 42 procedures RC- 15, Gado- 20 CIN ≥0.5 mg/dl at 48 h | Gadodiamide | up to 0.40 | [Cr] >1.5, mean [Cr] 2.2, range [Cr] 1.6 to 3.6 | RC- 6/15 (40%) GBC- 1/20 (5%) |
| Spinosa et al. (24), 2001 | Consecutive patients treated with Gado + CO2, CIN > 0.5 mg/dl at 48 h | Gadodiamide | <0.30 | [Cr] >1.5, mean [Cr] 2.7 | CIN: 3/95 (3%) |
| Sancak et al. (25), 2001 | n = 16, intravenous Gado for upper extremity or SVC | Gadodiamide | 0.30 | Mean [Cr] 1.5, range [Cr] 1.2 to 1.8 | Largest increase in [Cr] 0.2 mg/dl |
| Rieger et al. (26), 2002 | Prospective, n = 29, 32 procedures (IA and intravenous) CIN >0.5 mg/dl at 72 h | Gadopentetate | 0.34 ± 0.06 | [Cr] >1.5 mean [Cr] 3.6 | AKI: 1/29 (atheroemboli) |
| Total | N/A | N/A | Average dosage ∼0.26 (0.10 to 0.40) | Average mean [Cr] ∼2.36; range 1.2 to 3.6 | CIN: GBC: 0 to 5% RC: 17 to 40% |
↵a CIN, contrast-induced nephropathy; [Cr], serum creatinine concentration; CrCl, creatinine clearance; RC, iodinated radiocontrast; DSA, digital subtraction angiogram; IA, intra-arterial; LE, lower extremity; SVC, superior vena cava.