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.