Comparative effects of nonionic (iopamidol) and ionic (sodium and meglumine diatrizoate) contrast media for urography on urinary excretion of water and solutes

Abstract

Urinary water and solute excretion before and for 40 minutes after intravenous bolus injection of a nonionic (iopamidol) or an ionic medium (sodium meglumine diatrizoate) have been studied in subjects with normal renal function. Iopamidol produced less urinary losses of water, potassium, sodium, and chloride than did diatrizoate; uric acid excretion was also less enhanced. Surprisingly, both contrast agents produced a comparable increase in urinary pH and bicarbonate excretion. These data show that nonionic agents produce fewer changes in urinary excretion of water and solutes; the less enhanced excretion of uric acid after a nonionic medium may be an important reason to choose the latter agents for urography in patients at risk for urate neophropathy.

Efeitos cardiovasculares e renais da injeção intra-arterial de contraste radiológico iônico em cães com restrição hídrica

“…The two latter could be explained by osmotic diuresis-induced dilution. Some studies, in agreement with ours, have shown increased UE Na+ 12,31,32 and FE Na+ 32 after ionic and non-ionic radiological contrast, which seems to be independent of contrast osmolality. Increased sodium excretion cannot be explained by sodium content in radiological contrast: diatrizoate has high sodium concentration, while ioxilan, iopamidol, iohexol and other low osmolality contrasts have very low concentrations of this electrolyte.…”

Intravenous Injection of Ioxilan, Iohexol and Diatrizoate

“…Recently it has been shown that the non-ionic low osmolar IOXILAN, IOHEXOL AND DIATRIZOATE iopamidol increases the excretion of sodium in man, though not to the same extent as diatrizoate (6). Since ioxaglate has also been shown to inhibit the tubular reabsorption of sodium (5), the phenomenon seems independent of contrast medium osmolality and/or charge.…”