Renal Tolerance of Gadolinium-DTPA/Dimeglumine in Patients with Chronic Renal Failure

Pharmacokinetics, safety, and tolerability of gadoversetamide injection (OptiMARK) in subjects with central nervous system or liver pathology and varying degrees of renal function

“…2 The potential impact of gadolinium-based compounds on renal function has been evaluated at the standard dose of 0.1 mmol/kg as well as at 0.3 mmol/kg; both doses appear to be safe and not nephrotoxic. 3 Thus, doses of 0.1, 0.3, and 0.5 mmol/kg were selected to permit assessment of a potential dose response with regard to safety, tolerability, and pharmacokinetic parameters in subjects with normal as well as reduced renal function.…”

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

“…In one study in patients with a normal GFR, gadodiamide 0.3 mmol/kg reduced the creatinine clearance by 6% and increased the serum creatinine level by 4%, but these dif ferences were not significant [2], Our results are in agree ment with those from two other studies on Gd chelates in patients with impaired renal function. The serum creati nine concentration was unchanged after 0.1 mmol/kg Gd-DOTA in patients with a GFR < 60 ml/min [6], In anoth er patient group with a mean creatinine clearance of 34.5 ml/min, 0.1 mmol/kg Gd-DTPA did not change se rum creatinine [5], The risk of contrast medium induced nephropathy has been found to be increased in patients with a reduced GFR [17], These studies indicate that gad odiamide and other Gd chelates have a smaller effect on GFR than have iodinated contrast media. However, all studies with Gd chelates in patients with an impaired renal function were performed using a dose of 0.1 mmol/ kg.…”

“…the urinary ALP excretion was unchanged by gadodiamide, while the urinary NAG excretion was increased by 10-20% [2], In another study in patients with an impaired renal function, the urinary NAG excretion was increased by 40% 0-3 h after injection of Gd-DTPA and then normalized [5]. These changes in urinary enzyme excretion were consid erably smaller than those previously reported for ionic and non-ionic iodinated contrast media.…”

“…The uri nary NAG excretion was slightly increased during the period 0-3 h after injection, but then returned to baseline [5]. No effect on serum creatinine was observed after the same dose of Gd-DOTA (Dotarem®) in another study in patients with impaired renal function (serum creatinine 331 ± 42 pmol/1) [6].…”

Good MRI images: to Gad or not to Gad?

“…As early as 1992, Haustein et al [13] reported that GadDiethylene triamine pentaacetic acid (DTPA) [0.1 mmol/kg body weight (bw)] was harmless in a study of 21 patients with chronic renal failure (creatinine clearance 34.5 ml/min). Ten years later, Rieger et al [5] described only one episode of acute renal failure in 39 Gad-DTPA (0.35 mmol/kg bw) angiographic imaging procedures for 29 patients (59% of whom were diabetic) with renal insufficiency (mean serum creatinine: 3.6 mg/dl).…”