Nephropathy caused by iodinated contrast material might be overestimated

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The use of iodinated contrast material may be less damaging to the kidneys than previously recorded, according to a study that will appear in the August issue of American Journal of Roentgenology

“We reviewed patient records to determine the frequency and magnitude of serum creatinine changes in patients who had not received iodinated contrast material. We then compared that to previously published articles which found a relationship between contrast media, serum creatinine levels and nephropathy,” said the study’s lead author Jeffrey Newhouse, MD, a radiologist at the NewYork-Presbyterian/Columbia University Medical Center in New York City.

According to the study, conducted by researchers at Columbia University Medical Center in New York City, among the 32,161 patients who had not received contrast material, more than half showed a change of at least 25 percent, and more than 2/5 showed a change of at least 0.4 milligrams per deciliter.

“We found that the creatinine level increases just as often in those who do not receive contrast material as in those who do,” Newhouse said.

“These changes occurred in patients with both normal and abnormal initial creatinine values and were undoubtedly caused by the entire range of conditions, treatments and laboratory variations that may alter creatinine levels,” Newhouse said. “These changes were not different from those seen in previously published studies in which the patients received contrast media.”

“Because serum creatinine levels change frequently in the absence of iodinated contrast media material, prior studies of the relationship between iodinated contrast material and renal function must be interpreted with caution, and future experiments should have appropriate controls,” Newhouse said.

"We don't claim that IV contrast material never induces nephropathy, but it may do so less frequently and severely than previously thought. If subsequent experimentation proves its safety, it could be used more frequently in patients with renal failure," he concluded.