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Acta Radiologica
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Effects of the Low-Osmolality Contrast MediumIoversol (Optiray)
on Renal Function in a GeriatricPopulation
J.-P. Louvel, E. Primard, J. Henry, C. Houlette, A.
Weinstein & A. Janvresse
To cite this article: J.-P. Louvel, E. Primard, J. Henry,
C. Houlette, A. Weinstein & A. Janvresse
(1996) Effects of the Low-Osmolality Contrast Medium Ioversol
(Optiray) on Renal Function in aGeriatric Population, Acta
Radiologica, 37:6, 950-953
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Acta Radiologica
37
1996)
950-953
Printed in Denmark .All rights reserved
Copyright
Acta Radiologica
1996
A C T A R A D I O
L O G 1
C A
ISSN
0284-18.51
EFFECTS O F THE LOW-OSMOLALITY CONTRAST MEDIUM
IOVERSOL (OPTIRAY) ON RENA L FUN CTION IN A GERIATRIC
POPULATION
J.-P. LOWEL', . PIUMARD',. HENRY^ C.
HOULETTE~,
. W IN ST IN^ and A. JANVRESSE'
Service d Imagerie MCdicale, H6pital d e Bois Guillaume, CHR U
Rouen; and 2Service de Radiologie Adulte, CH G Le Havre;
France.
Abstract
Purpose: To asse ss the incidence of nephrotoxicity following
i.v. injection of the io-
dinated low-osmolality contrast medium ioversol 30 0 (Optiray)
in a geriatric popula-
tion compared with a control group aged under 6 0 years, neither
group presenting any
associated risk factors.
Material and Methods: CT with i.v. bolus injection of ioverso
l300 mg
I/ml
was per-
formed at a mean dose of 1 .36M.06 m lk g (range 1-2 m lk g
b.w.) in 47 patients aged
over 69 years. Serum creatinine level was measu red and
creatinine clearance was cal-
culated at 24, 48 and 72 h after the examination, and compared
to a reference serum
creatinine value taken before CT. The findings were com pared
with a control group of
44 patients aged under 6 0 years.
Results: No significant increase in serum creatinine (+0.6
mmoV1)
or in creatinine
clearance (+0.7 ml/min) was found during the course of 3 day s
after the injection. Only
one patient (aged
82)
presented an increase of
25
in serum cre atinine (109 mmolll).
Conclusion: The tri l did not demonstrate any significant
difference between the 2
groups, although the elderly patients had a subclinical renal
impairm ent revealed by the
decrease of the initial creatinine clearance. Th e use of
low-osmolality ioversol makes
it possible to perform exam ination with an iodinated contrast
agent without increasing
the incidence of nephrotoxicity in elderly subjects.
The mean increase in life expectancy is linked in
part to the diagnostic and therapeutic progress
achieved in the geriatric population. It is therefore
important to reduce the morbidity related to diag-
nostic investigations, particularly the nephrotoxicity
of contrast agents.
In review articles and retrospective studies (4, 5
17),
geriatric patients are considered to be at risk of
developing contrast nephrotoxicity (CN). However,
RICH CRECELIUS1
6)
evaluated the onset of CN in
elderly individuals after cardiac angiography to be
between 1.2 and 60 depending on absence or pres-
ence of several risk factors, values that they consid-
ered to be comparable to those observed in a
younger population.
Key words: Renal function, contrast me-
dia; C T, toxicity; ioversol.
Correspondence:
Jean-Pierre Louvel,
Service d Imagerie MCdicale,
HBpital de Bois Guillaum e, CHRU
Rouen, F-7603
1
Rouen Cedex, France.
FAX *33 35 6 0 70 29.
Accepted fo r publication
4
February
1996.
Regardless of these conflicting assessments, ex-
aminations involving the injection of a contrast
agent should be carried out with extreme caution in
geriatric patients. It is generally accepted that the
use of low-osmolality contrast ,media (LOCM) re-
duces the incidence of CN, particularly in high-risk
groups and more specifically in patients with pre-
existing renal insufficiency and diabetes mellitus (2,
The incidence
of
CN due to LOCM in elderly
subjects not presenting any other known risk factor
has not been established. The aim of this study was
to assess the degree of CN following the administra-
tion
of
a LOCM, ioversol300 (Optiray, Guerbet), in
a geriatric population compared with a control
3, 8-10).
950
8/16/2019 Effects of the Low Osmolality Contrast Medium Ioversol
Optiray on Renal Function in a Geriatric Population
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IOVERSOL EFFECT ON RENAL FUNCTION
IN
A GERIATRIC POPULATION
study of the effects of ionic and non-ionic monomeric and
dimeric contrast media in the rat. Acta Radiol. Suppl.
378
(1992), 123.
14. PERMAL.,
VERNY ., BELLIN .
F.,
GRELLET
.
GRIMALDI
A.: Nephropathie d ue aux produits de contraste iodks et di-
abhte. J. Radiol.
73 (1992), 79.
15.
PORTER
.
A.: Radio contrast induced nephropathy. Neph-
rol Dial. Transplant.
9,
Suppl.
4 (1994), 146.
16.
RICH
N. M. CKECEL ILJS. A.: Incidence, risk factors and
clinical course o acute renal insufficiency afte r
catheteriza-
tion in patients
70
years of age or older. Arch. Intern. Med.
150 (1990), 1237.
17.
SPINLER
.
A. GOLOFARD
.:
Nephrotoxicity of contrast
media following cardiac angiography. Pathogenesis, clini-
cal course, and preventive measures, including the role of
low osmolality contrast media. Am. Pharmacother.
26
(1992), 56.
18. TALERCIO
. P, VLESTRAR.
E., FISCHER.
D. BURNETI.
.
C.: Risk for renal dysfunction with cardiac angiography.
Ann. Int. Med.
104 (1986), 501.
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