Studies supporting nephrotoxicity of GBC agentsa
| Reference | Study | Contrast Agent | Dosage (mmol/kg) | Renal Function ([Cr] in mg/dl) | Result |
|---|---|---|---|---|---|
| Sam et al. (27), 2003 | n = 195 with CKD, no control group CIN >1.0 mg/d at 48 h with oligoanuria | Gadopentetate | 0.28 | CrCl <80 ml/min, CG 38.2 ± 16 ml/min, mean [Cr] 2.6 | CIN: 7/195, MRA: 3/153 (1.9%), DSA: 4/42 (9.5%) |
| Erley et al. (28), 2004 | Randomized prospective, n = 21, CIN >50%, decrease in GFR | Gadobutrol = 10 Iohexol = 11 | 0.57 ± 0.17 | [Cr] >1.5 or CrCl <50 ml/min per 1.73 m2, mean [Cr] 3.4 | CIN: GBC: 5/10 (50%) RC: 5/11 (45%) |
| Briguori et al. (30), 2006 | Retrospective, n = 25 (historical controls, n = 32), CIN ≥0.5 mg/dl within 48 h or dialysis within 5 d | Gadodiamide = 8 Gadobutrol = 17 3:1 mixture with RC | 0.60 ± 0.30 0.28 to 1.23 | [Cr] >2 mg/dl or CrCl <40 ml/min, mean [Cr] 2.3 | CIN: GBC: 7/25 (28%); RC: 2/32 (6.5%) |
| Ergun et al. (29), 2006 | Retrospective, n = 91, [Cr] measured pre-GBC, days 1, 3, and 7, and 1 mo, CIN ≥0.5 mg/dl within 72 h | Gadopentetate, gadodiamide, dotarem | 0.20 | Stages 3 and 4 CKD mean [Cr] 33 ml/min, range CrCl 15 to 58, mean [Cr] 4.0 | CIN: 11/91 (12.1%); CKD Stage 4: 9/11 with CIN |
| Kane et al. (31), 2008 | Retrospective, n = 163, [Cr] measured pre-GBC and within 7 d, CIN ≥0.5 mg/dl within 7 d | GBC agent, GBC + RC mixture, RC alone | GBC-76 ml, GBC + RC mixture-55 + 37 ml, RC-102 ml | Stages 3 to 5 CKD GBC [Cr] 2.77, GBC + RC [Cr] 2.63, RC [Cr] 2.48 | CIN: GBC: 5.3% GBC + RC: 10.5%; RC: 20.6% |
| Total | N/A | N/A | Average dosage ∼0.41 (0.20 to 0.60) | Average mean [Cr] ∼3.02, range 2.60 to 4.00 | CIN: GBC: 5.3 to 50.0%; RC: 6.5 to 45.0% |
↵a MRA, magnetic resonance angiography.