Background: Iso-osmolar iodixanol was shown to least affect very-short-term renal function. However, its short- and long-term renal effects after cardiovascular catheterizations in severe renal insufficiency remain unknown.
Methods: Patients undergoing elective cardiovascular catheterizations and having pre-procedural serum creatinine (Scr) > or =2.5 mg/dl were prospectively studied. The results were compared to those of historical controls who received iopromide.
Results: The iodixanol group included 27 patients, aged 73+/-1 years, and the case-matched control group consisted of another 27 patients, aged 71+/-1 years. The baseline Scr were 3.0+/-0.3 and 3.0+/-0.2 mg/dl respectively. Although the Scr at 3 months was similar, the Scr at 6 months was lower in the iodixanol group (2.7+/-0.3 vs 4.2+/-0.5 mg/dl, p = 0.017). The absolute and percentage increments in Scr at 3 months (0.0+/-0.2 vs 0.6+/-0.2 mg/dl, p = 0.014, and 1+/-4% vs 24+/-6%, p = 0.003, respectively) and 6 months (-0.3+/-0.2 vs 1.3+/-0.4 mg/dl, p = 0.001, and -10+/-5% vs 47+/-12%, p < 0.001, respectively) were lower in the iodixanol group.
Conclusions: Iodixanol better preserves short- and long-term renal outcomes in patients with severe baseline renal insufficiency.