Gadolinium contrast media are more nephrotoxic than a low osmolar iodine medium employing doses with equal x-ray attenuation in renal arteriography: An experimental study in pigs1

Elmståhl, Barbara; Nyman, Ulf; Leander, Peter; Chai, Chun-Ming; Frennby, Bo; Almén, Torsten

doi:10.1016/j.acra.2004.07.015

Cited by 48 publications

(57 citation statements)

References 46 publications

(47 reference statements)

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“…The present investigation confirms the results of a previous study [20], that the two Gd-CM depressed renal function more than the equi-molar solution of iohexol. Following injection of gadopentetate there was a severe deterioration of renal function with a median plasma halflife of the GFR marker of almost 60 hours in the earlier and 30 hours in the present study.…”

Section: Discussionsupporting

confidence: 92%

“…Anesthesia, heparinization, monitoring and the catheterization procedure have been described in detail elsewhere [20]. In summary introducers were placed in the right femoral artery and right internal jugular vein.…”

Section: Anesthesia Surgery and Catheterizationmentioning

confidence: 99%

“…Plasma concentration of the CM was determined with X-ray fluorescence technique as previously described [20].…”

Section: Determination Of Contrast Medium Concentrations In Plasmamentioning

confidence: 99%

“…Injections of 0.184M iohexol (70 mg I/ml), isoosmolal relative to plasma and roughly iso-attenuating with 0.5M Gd-CM at commonly used x-ray tube potentials of 70-90 peak kilovoltage (kVp) during XRA [10], had no effect on renal function any different from that of saline. The nephrotoxic effect of the CM in these animal experiments [20] The aim of the present study was to investigate the role of osmolality on depression of renal function using the same experimental model as in the previous study [20], i.e. injections of test solutions into the artery to ischemic porcine kidneys.…”

mentioning

confidence: 99%

“…It was recently shown that the HOCM gadopentetate caused a severe depression of renal function when injected into renal arteries of ischemic porcine kidneys [20]. The LOCM gadodiamide caused a markedly less effect on glomerular filtration rate (GFR), but still significantly more than equal volumes of an equi-molar 0.5M molecular concentration of the ratio 3:1 I-CM iohexol (190 mg I/ml).…”

mentioning

confidence: 99%

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Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

et al. 2006

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Section: Discussionsupporting

confidence: 92%

Section: Anesthesia Surgery and Catheterizationmentioning

confidence: 99%

“…Plasma concentration of the CM was determined with X-ray fluorescence technique as previously described [20].…”

Section: Determination Of Contrast Medium Concentrations In Plasmamentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

et al. 2006

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Utilization of nanoparticles as X‐ray contrast agents for diagnostic imaging applications

Vega

Häfeli

2014

Contrast Media & Molecular

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Among all the diagnostic imaging modalities, X-ray imaging techniques are the most commonly used owing to their high resolution and low cost. The improvement of these techniques relies heavily on the development of novel X-ray contrast agents, which are molecules that enhance the visibility of internal structures within the body in X-ray imaging. To date, clinically used X-ray contrast agents consist mainly of small iodinated molecules that might cause severe adverse effects (e.g. allergies, cardiovascular diseases and nephrotoxicity) in some patients owing to the large and repeated doses that are required to achieve good contrast. For this reason, there is an increasing interest in the development of alternative X-ray contrast agents utilizing elements with high atomic numbers (e.g. gold, bismuth, ytterbium and tantalum), which are well known for exhibiting high absorption of X-rays. Nanoparticles (NPs) made from these elements have been reported to have better imaging properties, longer blood circulation times and lower toxicity than conventional iodinated X-ray contrast agents. Additionally, the combination of two or more of these elements into a single carrier allows for the development of multimodal and hybrid contrast agents. Herein, the limitations of iodinated X-ray contrast agents are discussed and the parameters that influence the efficacy of X-ray contrast agents are summarized. Several examples of the design and production of both iodinated and iodine-free NP-based X-ray contrast agents are then provided, emphasizing the studies performed to evaluate their X-ray attenuation capabilities and their toxicity in vitro and in vivo.

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MR contrast agents: Physical and pharmacologic basics

Lin

Brown

2007

Magnetic Resonance Imaging

223

175

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Since approval of the first magnetic resonance (MR) contrast agent was granted in 1988, there has been remarkable growth in the utilization of intravenous gadolinium (Gd)-based agents. Currently it is estimated that nearly half of all MR studies performed are contrast-enhanced. Despite containing a toxic heavy metal, these agents have proven to be not only an effective diagnostic adjunct to non-enhanced MRI, but also remarkably well tolerated and safe. As a result, conventional wisdom has been that MR contrast media are "biologically inert," a notion that is clearly false. Ultimately, it is the radiologist's responsibility to understand the potential adverse effects of Gd-based agents and the special situations in which they are likely to occur; however, the basic pharmacology of contrast agents is generally not included in medical school curricula or formally taught in residency. The purpose of this review is to discuss the mechanism of action of MR contrast agents and relevant aspects of their clinical pharmacology, including effects on the cardiovascular and renal systems, potential laboratory errors, and special situations involving women and children. We also briefly discuss the issue of nephrogenic systemic fibrosis (NSF).

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Gadolinium contrast media are more nephrotoxic than a low osmolar iodine medium employing doses with equal x-ray attenuation in renal arteriography: An experimental study in pigs1

Cited by 48 publications

References 46 publications

Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

Utilization of nanoparticles as X‐ray contrast agents for diagnostic imaging applications

MR contrast agents: Physical and pharmacologic basics

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