Table 4.

Meta-analyses comparing iso-osmolal and low-osmolal contrast media in terms of renal safety

Metaanalyses	Baseline renal functions	Procedure/administration route	Compared drugs	Results
McCullough et al[104] (16 trials)	Both normal GFR and CKD	PTCA (intra-arterial)	Iodixanol (IOCM) vs various LOCM	Iodixanol safer than LOCM, e.p. in patients with CKD or CKD + diabetes mellitus
Reed et al[23] (16 trials)	Both normal GFR and CKD	PTCA + CT (intra-arterial + intravenous)	Iodixanol (IOCM) vs various LOCM	Overall, no difference. However, iodixanol safer than ioxaglate and iohexol
Heinrich et al[48] (25 trials)	Both normal GFR and CKD	PTCA + IV urography + CT (intra-arterial + intravenous)	Iodixanol (IOCM) vs various LOCM	Overall, no difference. However, iodixanol safer than iohexol in CKD patients when CM used via intra-arterial route
From et al[105] (36 trials)	Both normal GFR and CKD	PTCA + CT (intra-arterial + intravenous)	Iodixanol (IOCM) vs various LOCM	Overall, no difference. Iodixanol safer than iohexol
Eng et al[24] (29 trials)	Both normal GFR and CKD	PTCA + IV urography + CT (intra-arterial + intravenous)	Iodixanol (IOCM) vs various LOCM	Iodixanol slightly safer than LOCM but the lower risk did not exceed a minimally important clinical difference

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