Review Article

Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention

Table 6

Studies assessing incidence of CIN in patients with exposure of gadolinium as contrast.

StudySample designContrast doseRenal statusCIN definitionRenal outcomePreventive treatment used

Spinosa (2000) [112]35-Randomized0.29 mmol/kg (0.13–0.40 mmol/kg) Gadolinium; 51 mL (33–80 mL) nonionic contrastCr 1.5 mg/dL 0.5 mg/dL increase in [Cr ] within 48 hours5 % (1/20) exposed to Gadolinium; 40% (6/15) exposed to nonionic contrastVolume administration

Erley (2004) [113]21-Prospective, randomized study  mmol/kg Gadolinium;  mmol/kg IohexolCr 1.5 mg/dL or GFR 50 mL/min 50% decrease in GFR50% (5/10) exposed to Gadolinium and 45% (5/11) exposed to IohexolVolume administration

Briguori (2006) [114]57-Retrospective study  mmol/kg Gadolinium based;  mL IodixanolCr 2 mg/dL or CrCL 40 mL/min 0.5 mg/dL increase in [Cr ] within 48 hours or need for dialysis within 5 days28% (7/ 25) exposed to Gadolinium plus iodinated contrast and 6.5% (2/32) exposed to iodinated contrast aloneNormal saline plus N-acetylcysteine

Reed (2007) [115]169-Retrospective Study  mL Gadolinium (with Iodinated contrast dilution);  mL iodinated contrastCrCl 60 mL/min/1.73  , a serum Cr level 1.5 mL/dL, and not on hemodialysis. 0.5 mg/dL increase in [Cr] within 5 days16% (14/90) of those exposed to diluted Gadolinium and 14% (11/79) of Iodinated contrastN-acetylcysteine plus Volume administration

Kane [38] (2008)163-Retrospective Study3 comparative groups receiving  mL Gadolinium; Gadolinium (with Iodinated contrast); Iodinated contrastCr 2 mg/dL 0.5 mg/dL increase in [Cr] within 7 days5.3% (3/57) in Gadolinium only; 10.5% (4/38) in Gadolinium Iodinated Contrast; 20.6% (14/68) in Iodinated contrast aloneN-acetylcysteine plus Volume administration

CrCL: Creatinine Clearance; Cr: Serum Creatinine GFR: Glomerular Filtration Rate.