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Charanjit S Rihal - One of the best experts on this subject based on the ideXlab platform.
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Iodixanol versus low osmolar contrast media for prevention of contrast induced nephropathy meta analysis of randomized controlled trials
Circulation-cardiovascular Interventions, 2010Co-Authors: Aaron M From, Firas Al J Badarin, Furman S Mcdonald, Brian J Bartholmai, Stephen S Cha, Charanjit S RihalAbstract:Background —Contrast-induced nephropathy (CIN) is associated with significant morbidity and mortality. The objective of our meta-analysis was to assess the efficacy of Iodixanol compared with low-osmolar contrast media (LOCM) for prevention of CIN. Methods and Results —We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and internet sources of cardiology trial results for individual and relevant reviews of randomized, controlled trials, for the terms contrast media, contrast nephropathy, renal failure, Iodixanol, Visipaque, and low-osmolar contrast media. All studies reported an incidence rate of CIN for each study group; there was no restriction on the definition of CIN. There were no restrictions on journal type or patient population. Overall, 36 trials were identified for analysis of aggregated summary data on 7166 patients; 3672 patients received Iodixanol and 3494 patients received LOCM. Overall, Iodixanol showed no statistically significant reduction in CIN incidence below that observed with heterogeneous comparator agents ( P =0.11). Analysis of patient subgroups revealed that there was a significant benefit of Iodixanol when compared with iohexol alone (odds ratio, 0.25; 95% confidence interval, 0.11 to 0.55; P Conclusions —Analysis of aggregated summary data from multiple randomized, controlled trials of Iodixanol against diverse LOCMs for heterogeneous procedures and definitions of CIN show an Iodixanol-associated reduction that is suggestive but statistically nonsignificant.
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Iodixanol versus low osmolar contrast media for prevention of contrast induced nephropathy
Circulation-cardiovascular Interventions, 2010Co-Authors: Aaron M From, Firas Al J Badarin, Furman S Mcdonald, Brian J Bartholmai, Stephen S Cha, Charanjit S RihalAbstract:Background—Contrast-induced nephropathy (CIN) is associated with significant morbidity and mortality. The objective of our meta-analysis was to assess the efficacy of Iodixanol compared with low-osmolar contrast media (LOCM) for prevention of CIN. Methods and Results—We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and internet sources of cardiology trial results for individual and relevant reviews of randomized, controlled trials, for the terms contrast media, contrast nephropathy, renal failure, Iodixanol, Visipaque, and low-osmolar contrast media. All studies reported an incidence rate of CIN for each study group; there was no restriction on the definition of CIN. There were no restrictions on journal type or patient population. Overall, 36 trials were identified for analysis of aggregated summary data on 7166 patients; 3672 patients received Iodixanol and 3494 patients received LOCM. Overall, Iodixanol showed no statistically significant reduction in CIN incidence below that ob...
Hitinder S Gurm - One of the best experts on this subject based on the ideXlab platform.
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the relative renal safety of Iodixanol and low osmolar contrast media in patients undergoing percutaneous coronary intervention insights from blue cross blue shield of michigan cardiovascular consortium bmc2
Journal of Invasive Cardiology, 2010Co-Authors: Michael C Reed, Mauro Moscucci, Dean E Smith, David Share, Thomas Lalonde, Syed A Mahmood, Chris Dhaem, Richard Mcnamara, Adam Greenbaum, Hitinder S GurmAbstract:Contrast-induced acute kidney injury (CI-AKI) is a common complication of percutaneous coronary intervention (PCI). Current guidelines support the use of Iodixanol (Visipaque®, GE Healthcare, Princeton, New Jersey) in patients at high risk for CI-AKI. Recent trials and meta-analyses have shown no difference in CI-AKI when Iodixanol is compared to low-osmolar contrast media (LOCM). We evaluated the incidence of CI-AKI, in-hospital dialysis and in-hospital death in 58,957 patients who underwent PCI in 2007 and 2008 in a large regional consortium of 31 hospitals and who were treated with Iodixanol (n = 17,814) or LOCM (n = 41,143). Propensity-matched analysis was performed to adjust for differences in baseline variables. Patients treated with Iodixanol compared to those treated with LOCM were slightly older, had more medical comorbidities and a higher baseline creatinine (1.35 ± 1.07 mg/dL versus 1.10 ± 0.85 mg/dL; p < 0.0001). In propensity-matched, risk-adjusted models, there was no significant difference between Iodixanol and LOCM in the risk of CIAKI (4.54% vs. 4.14%; p = 0.14), need for dialysis (0.37% vs. 0.43%; p = 0.35) or death (1.46% vs. 1.39%; p = 0.18). Among patients undergoing PCI, the use of Iodixanol was more frequent in older patients with more comorbidities and worse baseline renal function. There was no difference in the adjusted risk of CI-AKI among patients treated with Iodixanol compared with those treated with LOCM.
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the relative renal safety of Iodixanol compared with low osmolar contrast media a meta analysis of randomized controlled trials
Jacc-cardiovascular Interventions, 2009Co-Authors: Michael C Reed, Mauro Moscucci, Pascal Meier, Umesh U Tamhane, Kathy Welch, Hitinder S GurmAbstract:Objectives We sought to compare the nephrotoxicity of the iso-osmolar contrast medium, Iodixanol, to low-osmolar contrast media (LOCM). Background Contrast-induced acute kidney injury (CI-AKI) is a common cause of in-hospital renal failure. A prior meta-analysis suggested that Iodixanol (Visipaque, GE Healthcare, Princeton, New Jersey) was associated with less CI-AKI than LOCM, but this study was limited by ascertainment bias and did not include the most recent randomized controlled trials. Methods We searched Medline, Embase, ISI Web of Knowledge, Google Scholar, Current Contents, and International Pharmaceutical Abstracts databases, and the Cochrane Central Register of Controlled Trials from 1980 to November 30, 2008, for randomized controlled trials that compared the incidence of CI-AKI with either Iodixanol or LOCM. Random-effects models were used to calculate summary risk ratios (RR) for CI-AKI, need for hemodialysis, and death. Results A total of 16 trials including 2,763 subjects were pooled. There was no significant difference in the incidence of CI-AKI in the Iodixanol group than in the LOCM group overall (summary RR: 0.79, 95% confidence interval [CI]: 0.56 to 1.12, p = 0.19). There was no significant difference in the rates of post-procedure hemodialysis or death. There was a reduction in CI-AKI when Iodixanol was compared with ioxaglate (RR: 0.58, 95% CI: 0.37 to 0.92; p = 0.022) and iohexol (RR: 0.19, 95% CI: 0.07 to 0.56; p = 0.002), but no difference when compared with iopamidol (RR: 1.20, 95% CI: 0.66 to 2.18; p = 0.55), iopromide (RR: 0.93, 95% CI: 0.47 to 1.85; p = 0.84), or ioversol (RR: 0.92, 95% CI: 0.60 to 1.39; p = 0.68). Conclusions This meta-analysis including 2,763 subjects suggests that Iodixanol, when compared with LOCM overall, is not associated with less CI-AKI. The relative renal safety of LOCM compared with Iodixanol may vary based on the specific type of LOCM.
Kazuhisa Furuhama - One of the best experts on this subject based on the ideXlab platform.
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Estimation of glomerular filtration rate in dogs by a single-blood sample method involving Iodixanol.
American Journal of Veterinary Research, 2015Co-Authors: Y. Sasaki, Masaaki Katayama, Ryosuke Iwama, Shunsuke Shimamura, Yuji Uzuka, Koichi Yabe, Kiyoshi Takasuna, Hiroshi Satoh, Kazuhisa FuruhamaAbstract:OBJECTIVE To establish a simplified single-blood-sample method (SBSM) involving Iodixanol to estimate glomerular filtration rate (GFR) in dogs and compare data provided by that procedure with data provided by a conventional multiple-blood-sample method (MBSM) involving inulin. ANIMALS 26 healthy dogs and 36 dogs with naturally occurring renal disease. PROCEDURES Dogs were used in various preliminary experiments to establish protocols for the SBSM and the MBSM of GFR estimation. To evaluate the relationship between GFRs obtained by the SBSM and the MBSM each involving Iodixanol, Iodixanol (40 mg of I/kg) was administered IV to 26 healthy dogs and 36 dogs with renal disease; blood sample collection was performed before and at 60, 90, and 120 minutes after the injection. To evaluate the relationship between GFRs obtained by the SBSM involving Iodixanol and the MBSM involving inulin, Iodixanol (40 mg of I/kg) and inulin (50 mg/kg) were coadministered IV to 22 healthy dogs and 3 dogs with renal disease, follow...
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Estimation of glomerular filtration rate in calves using the contrast medium Iodixanol
The Veterinary Journal, 2012Co-Authors: Kyoko Imai, Norio Yamagishi, Norimoto Okura, Takumi Fukuda, Toh-ichi Hirata, Keiji Okada, Shigeru Sato, Kazuhisa FuruhamaAbstract:Abstract To develop a simple procedure for estimating glomerular filtration rate (GFR) in calves, a three-sample method using Iodixanol was first compared to that using the standard agent inulin. Iodixanol and inulin were co-administered intravenously to calves at 40 mg I/kg and 40 mg/kg, respectively, and blood was collected 30, 60, 120, and 180 min later. Serum Iodixanol and inulin concentrations were separately determined by high performance liquid chromatography and colorimetry. Serum urea nitrogen (UN) and creatinine concentrations were also measured. GFR estimated by Iodixanol was consistent with that using inulin in clinically healthy calves. Based on GFR estimations in healthy calves and those renal-loaded with Iodixanol, it was found that the serum creatinine concentrations became elevated when GFR decreased to 60% of the reference value. In contrast, serum UN concentrations fluctuated widely, presumably due to extra-renal factors. When GFR was estimated using the three-sample method and compared with the single-blood-sample method, 62/69 (90%) of samples tested were within the agreement plots. The results demonstrated that the single-blood-sample method using Iodixanol may be useful in monitoring GFR in calves.
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Simplified procedure for the estimation of glomerular filtration rate following intravenous administration of Iodixanol in cats
American Journal of Veterinary Research, 2012Co-Authors: Rieko Katayama, Norio Yamagishi, Jun Saito, Masaaki Katayama, Tetsuro Yamashita, Masaki Kato, Kazuhisa FuruhamaAbstract:Objective—To compare the use of a single-sample method involving IV administration of Iodixanol with a multisample method involving inulin for the estimation of glomerular filtration rate (GFR) in cats. Animals—24 cats, including 15 healthy cats and 9 cats with naturally occurring renal diseases. Procedures—Each cat was coadministered Iodixanol (a nonionic contrast medium; dose providing 40 mg of I/kg) and inulin (50 mg/kg), IV, and blood samples were collected 60, 90, and 120 minutes later. Serum Iodixanol and inulin concentrations were determined by means of high-performance liquid chromatography and colorimetry, respectively. Serum urea nitrogen and creatinine concentrations were also measured. Results—Analysis of the data from healthy cats and cats with naturally occurring renal diseases revealed an excellent correlation between GFR values estimated by the multisample and single-sample methods with Iodixanol. Likewise, GFR values estimated from the single-sample method with Iodixanol were closely corr...
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Estimation of glomerular filtration rate in rabbits by a single-sample method using Iodixanol.
Laboratory Animals, 2012Co-Authors: Y Michigoshi, Norio Yamagishi, Rieko Katayama, Jun Saito, Masaki Kato, Hiroshi Satoh, Kazuhisa FuruhamaAbstract:To estimate the glomerular filtration rate (GFR) in conscious rabbits, a single-sample method using the non-ionic contrast medium Iodixanol was compared with a three-sample method using the standard agent inulin. Iodixanol and inulin were co-administered intravenously to male New Zealand White rabbits at 60 mg I/kg and 40 mg/kg, respectively, and blood was collected 30, 60, 90 and 120 min later. Serum Iodixanol and inulin concentrations were separately determined by high performance liquid chromatography and colorimetry, respectively. Serum urea nitrogen (UN) and creatinine concentrations were also determined. Based on the data from healthy and cisplatin-treated rabbits, the GFR estimated by Iodixanol was well consistent with that by inulin. Further, when the GFR decreased to more than 60% of the reference value, serum creatinine concentrations became elevated. However, serum UN concentrations exhibited wide fluctuations, presumably due to a difference in renal handlings. The single-sample method using Iodixanol was considered to be an expedient tool in both clinical and research settings, because the stress due to a multi-sample method was reduced.
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Optimum conditions for serum clearance of Iodixanol, applicable to the estimation of glomerular filtration rate in horses.
Veterinary Research Communications, 2011Co-Authors: Hiroshi Satoh, Masaki Kato, Jun Saito, Sumito Abe, Kazuhisa FuruhamaAbstract:To estimate the glomerular filtration rate (GFR) in horses, an optimum dose of the nonionic contrast medium Iodixanol as a tracer was assessed with blood-sample times. Iodixanol was administered intravenously at 10–40 mg I/kg to geldings and mares, and blood was collected 30, 60, 90, 120, 150, and 180 min later. Serum Iodixanol concentration was determined by high-performance liquid chromatography (HPLC), and serum urea nitrogen (UN) and creatinine concentrations were also measured. The combination of 20 mg I/kg Iodixanol and sampling times of 60, 90, and 120 min after injection was considered to be appropriate for practical use. In clinically healthy horses, the reference values were determined to be 1.90 ± 0.03 ml/min/kg (150.8 ± 2.94 ml/min/m2), consistent with historical data using different tracers. The result suggests that serum clearance of Iodixanol is a ready-to-use tool for a screening of alterations in the equine GFR, although it is necessary to perform a more longitudinal study using horses with a variety of renal functions.
Aaron M From - One of the best experts on this subject based on the ideXlab platform.
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Iodixanol versus low osmolar contrast media for prevention of contrast induced nephropathy meta analysis of randomized controlled trials
Circulation-cardiovascular Interventions, 2010Co-Authors: Aaron M From, Firas Al J Badarin, Furman S Mcdonald, Brian J Bartholmai, Stephen S Cha, Charanjit S RihalAbstract:Background —Contrast-induced nephropathy (CIN) is associated with significant morbidity and mortality. The objective of our meta-analysis was to assess the efficacy of Iodixanol compared with low-osmolar contrast media (LOCM) for prevention of CIN. Methods and Results —We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and internet sources of cardiology trial results for individual and relevant reviews of randomized, controlled trials, for the terms contrast media, contrast nephropathy, renal failure, Iodixanol, Visipaque, and low-osmolar contrast media. All studies reported an incidence rate of CIN for each study group; there was no restriction on the definition of CIN. There were no restrictions on journal type or patient population. Overall, 36 trials were identified for analysis of aggregated summary data on 7166 patients; 3672 patients received Iodixanol and 3494 patients received LOCM. Overall, Iodixanol showed no statistically significant reduction in CIN incidence below that observed with heterogeneous comparator agents ( P =0.11). Analysis of patient subgroups revealed that there was a significant benefit of Iodixanol when compared with iohexol alone (odds ratio, 0.25; 95% confidence interval, 0.11 to 0.55; P Conclusions —Analysis of aggregated summary data from multiple randomized, controlled trials of Iodixanol against diverse LOCMs for heterogeneous procedures and definitions of CIN show an Iodixanol-associated reduction that is suggestive but statistically nonsignificant.
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Iodixanol versus low osmolar contrast media for prevention of contrast induced nephropathy
Circulation-cardiovascular Interventions, 2010Co-Authors: Aaron M From, Firas Al J Badarin, Furman S Mcdonald, Brian J Bartholmai, Stephen S Cha, Charanjit S RihalAbstract:Background—Contrast-induced nephropathy (CIN) is associated with significant morbidity and mortality. The objective of our meta-analysis was to assess the efficacy of Iodixanol compared with low-osmolar contrast media (LOCM) for prevention of CIN. Methods and Results—We searched MEDLINE, the Cochrane Central Register of Controlled Trials, and internet sources of cardiology trial results for individual and relevant reviews of randomized, controlled trials, for the terms contrast media, contrast nephropathy, renal failure, Iodixanol, Visipaque, and low-osmolar contrast media. All studies reported an incidence rate of CIN for each study group; there was no restriction on the definition of CIN. There were no restrictions on journal type or patient population. Overall, 36 trials were identified for analysis of aggregated summary data on 7166 patients; 3672 patients received Iodixanol and 3494 patients received LOCM. Overall, Iodixanol showed no statistically significant reduction in CIN incidence below that ob...
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Iodixanol Compared to Iohexol for Contrast Procedures: A Case-Matched Retrospective Cohort Study
Acta Radiologica, 2008Co-Authors: Aaron M From, Brian J Bartholmai, Amy W. Williams, Furman S McdonaldAbstract:Background: Previous studies that have attempted to evaluate the effectiveness of an iso-osmolar contrast medium (IOCM) Iodixanol compared to a low-osmolar contrast medium (LOCM) for contrast procedures show variable results.Purpose: To evaluate the nephrotoxicity of the IOCM Iodixanol compared to the LOCM iohexol.Material and Methods: We performed a retrospective cohort study from April 2004 to March 2006. All contrast procedures with a pre- and post-exposure creatinine value were evaluated for inclusion. Contrast nephropathy (CN) was defined as post-exposure creatinine elevation of ≥25% or >0.5 mg/dl within 7 days of contrast exposure. Cases of Iodixanol exposure were matched to control cases of iohexol exposure (1:1) based on age, sex, presence of diabetes, pre-exposure creatinine value, and type of imaging study performed. We matched 397 cases of Iodixanol (IOCM) exposure to 397 cases of iohexol (LOCM) exposure. Cases of Iodixanol which could not be matched to controls were not included in the analysi...
Michael C Reed - One of the best experts on this subject based on the ideXlab platform.
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the relative renal safety of Iodixanol and low osmolar contrast media in patients undergoing percutaneous coronary intervention insights from blue cross blue shield of michigan cardiovascular consortium bmc2
Journal of Invasive Cardiology, 2010Co-Authors: Michael C Reed, Mauro Moscucci, Dean E Smith, David Share, Thomas Lalonde, Syed A Mahmood, Chris Dhaem, Richard Mcnamara, Adam Greenbaum, Hitinder S GurmAbstract:Contrast-induced acute kidney injury (CI-AKI) is a common complication of percutaneous coronary intervention (PCI). Current guidelines support the use of Iodixanol (Visipaque®, GE Healthcare, Princeton, New Jersey) in patients at high risk for CI-AKI. Recent trials and meta-analyses have shown no difference in CI-AKI when Iodixanol is compared to low-osmolar contrast media (LOCM). We evaluated the incidence of CI-AKI, in-hospital dialysis and in-hospital death in 58,957 patients who underwent PCI in 2007 and 2008 in a large regional consortium of 31 hospitals and who were treated with Iodixanol (n = 17,814) or LOCM (n = 41,143). Propensity-matched analysis was performed to adjust for differences in baseline variables. Patients treated with Iodixanol compared to those treated with LOCM were slightly older, had more medical comorbidities and a higher baseline creatinine (1.35 ± 1.07 mg/dL versus 1.10 ± 0.85 mg/dL; p < 0.0001). In propensity-matched, risk-adjusted models, there was no significant difference between Iodixanol and LOCM in the risk of CIAKI (4.54% vs. 4.14%; p = 0.14), need for dialysis (0.37% vs. 0.43%; p = 0.35) or death (1.46% vs. 1.39%; p = 0.18). Among patients undergoing PCI, the use of Iodixanol was more frequent in older patients with more comorbidities and worse baseline renal function. There was no difference in the adjusted risk of CI-AKI among patients treated with Iodixanol compared with those treated with LOCM.
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the relative renal safety of Iodixanol compared with low osmolar contrast media a meta analysis of randomized controlled trials
Jacc-cardiovascular Interventions, 2009Co-Authors: Michael C Reed, Mauro Moscucci, Pascal Meier, Umesh U Tamhane, Kathy Welch, Hitinder S GurmAbstract:Objectives We sought to compare the nephrotoxicity of the iso-osmolar contrast medium, Iodixanol, to low-osmolar contrast media (LOCM). Background Contrast-induced acute kidney injury (CI-AKI) is a common cause of in-hospital renal failure. A prior meta-analysis suggested that Iodixanol (Visipaque, GE Healthcare, Princeton, New Jersey) was associated with less CI-AKI than LOCM, but this study was limited by ascertainment bias and did not include the most recent randomized controlled trials. Methods We searched Medline, Embase, ISI Web of Knowledge, Google Scholar, Current Contents, and International Pharmaceutical Abstracts databases, and the Cochrane Central Register of Controlled Trials from 1980 to November 30, 2008, for randomized controlled trials that compared the incidence of CI-AKI with either Iodixanol or LOCM. Random-effects models were used to calculate summary risk ratios (RR) for CI-AKI, need for hemodialysis, and death. Results A total of 16 trials including 2,763 subjects were pooled. There was no significant difference in the incidence of CI-AKI in the Iodixanol group than in the LOCM group overall (summary RR: 0.79, 95% confidence interval [CI]: 0.56 to 1.12, p = 0.19). There was no significant difference in the rates of post-procedure hemodialysis or death. There was a reduction in CI-AKI when Iodixanol was compared with ioxaglate (RR: 0.58, 95% CI: 0.37 to 0.92; p = 0.022) and iohexol (RR: 0.19, 95% CI: 0.07 to 0.56; p = 0.002), but no difference when compared with iopamidol (RR: 1.20, 95% CI: 0.66 to 2.18; p = 0.55), iopromide (RR: 0.93, 95% CI: 0.47 to 1.85; p = 0.84), or ioversol (RR: 0.92, 95% CI: 0.60 to 1.39; p = 0.68). Conclusions This meta-analysis including 2,763 subjects suggests that Iodixanol, when compared with LOCM overall, is not associated with less CI-AKI. The relative renal safety of LOCM compared with Iodixanol may vary based on the specific type of LOCM.
