Gadodiamide in Renal Transplant Patients: Effects on Renal Function and Usefulness as a Glomerular Filtration Rate Marker

Abstract

Gadodiamide at a dose of 0.1 mmol/kg was administered intravenously to 10 renal transplanted patients with stable, impaired, or slowly deteriorating renal function (serum creatinine 194-362 μmol/l). The patients were referred for contrast medium enhanced magnetic resonance imaging to rule out possible graft circulation abnormalities. The excretion of gadodiamide in urine was prolonged as compared with healthy controls. After 120 h 92% of the injected dose was excreted in urine and only 0.4% in faeces. The plasma clearance of gadodiamide was 28.6 ± (SD) 5.5 ml/min (n = 10), and the renal clearance (0-72 h) was 26.3 ml/min. The renal clearance of ¹²⁵I-iothalamate for the same time period was 27.9 ± 5.3 ml/min. Thus, gadodiamide is eliminated by glomerular filtration also in renal transplant patients with moderately to severe impaired renal function, and gadodiamide clearance may serve as an alternative marker for the determination of the glomerular filtration rate. Serum values of creatinine and β₂-microglobulin and creatinine clearance were unchanged by gadodiamide and neither was the urinary enzyme excretion significantly changed. These results suggest that the renal tolerance to gadodiamide is good also in renal transplant patients with impaired renal function.

Elimination of the non-ionic X-ray contrast media iodixanol and iohexol in patients with severely impaired renal function

“…Plasma and renal iothalamate clearances were similar in both patient groups, confirming the suitability of this compound as a marker of GFR also in these patients. The small variation observed was not clinically significant and was probably due to random methodological variation [25].…”

The Impact of Excess Ligand on the Retention of Nonionic, Linear Gadolinium-Based Contrast Agents in Patients With Various Levels of Renal Dysfunction: A Review and Simulation Analysis

“…Kidney dysfunction was modeled by reducing the blood-to-urine and blood-to-kidney elimination constants for Gd and GBCAs by the fraction of normal renal function used in the simulation (1%, 5%, 10%, 25%, 50% and 100%); excess ligand was modeled by declaring initial conditions with the administered dose and excess ligand in the blood compartment. The development and validation of this model in normal renal function will be the subject of a future report, but the present analysis includes simulated concentration-time profiles alongside those observed in patients 43,44,45 for the purposes of partial validation.…”

Gadodiamide as an Alternative Contrast Agent during Angioplasty in Patients with Contraindications to Iodinated Media

“…19,20 The manufacturer-recom-ࡗ ࡗ PTA ϭ percutaneous transluminal angioplasty, CFA ϭ common femoral artery, SFA ϭ superficial femoral artery, CIA ϭ common iliac artery, EIA ϭ external iliac artery, POP ϭ popliteal artery. * At the 3-month follow-up, both patients were stage I with completely healed wounds.…”