Contrast-induced acute kidney injury: A review of practical points

Table 3 Major studies comparing low-osmolal and iso-osmolal contrast media in terms of renal safety

Ref.	Baseline renal functions/patient population	Procedure/administration route	Compared drugs	Aim of the study/primary end points	Results
Feldkamp et al[94]	Normal GFR	PTCA (intra-arterial)	Iodixanol (IOCM) vs Iopromide (LOCM)	≥ 25% increase in SCr at 48 h	No difference
Hardiek et al[95]	Normal GFR, diabetic patients	PTCA (intra-arterial)	Iodixanol (IOCM) vs Iopamidol (LOCM)	≥ 25% increase in SCr days 1, 3 and 7	No difference
Aspelin et al[96] (NEPHRIC)	CKD, diabetic patients	PTCA (intra-arterial)	Iodixanol (IOCM) vs Iohexol (LOCM)	Peak increase in SCr day 0–3	Iso-osmolal safer than low-osmolal CM
Jo et al[97] (RECOVER)	CKD	PTCA (intra-arterial)	Iodixanol (IOCM) vs Ioxaglate (LOCM)	Increase in SCr ≥ 25% or ≥ 0.5 mg/dL within 2 d	Iso-osmolal safer than low-osmolal CM
Solomon et al[98] (CARE)	CKD	PTCA (intra-arterial)	Iodixanol (IOCM) vs Iopamidol (LOCM)	Increase in SCr > 0.5 mg/dL at 45-120 h	No difference
Rudnick et al[99] (VALOR)	CKD	PTCA (intra-arterial)	Iodixanol (IOCM) vs Ioversol (LOCM)	Increase in SCr > 0.5 mg/dL within 72 h	No difference
Barrett et al[8] (IMPACT)	CKD	CT (intravenous)	Iodixanol (IOCM) vs Iopamidol (LOCM)	Increase in SCr > 0.5 mg/dL or ≥ 25% at 48–72 h	No difference
Kuhn et al[100] (PREDICT)	CKD	CT (intravenous)	Iodixanol (IOCM) vs Iopamidol (LOCM)	Increase in SCr > 0.5 mg/dL within 48-72 h	No difference
Thomsen et al[101] (ACTIVE)	CKD	CT (intravenous)	Iodixanol (IOCM) vs Iomeprol (LOCM)	Increase in SCr > 0.5 mg/dL at 48-72 h	Low-osmolal safer than iso-osmolal CM
Nguyen et al[102]	CKD	CT (intravenous)	Iodixanol (IOCM) vs Iopromide (LOCM)	Peak rise in SCr days 1-3	Iso-osmolal safer than low-osmolal CM
Wessely et al[103]	CKD	PTCA (intra-arterial)	Iodixanol (IOCM) vs İomeprol (LOCM)	Peak increase in SCr	No difference

CM: Contrast media; CKD: Chronic kidney disease; LOCM: Low-osmolal contrast media; CT: Computed tomography; PTCA: Percutaneous transluminal coronary angioplasty.