A COMPARATIVE STUDY ON IODIXANOL VERSUS IOHEXOL IN INTRAVENOUS PYELOGRAPHY STUDIES IN A TERTIARY CARE HOSPITAL- A RANDOMIZED CONTROL STUDY
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Keywords
contrast, ivp, Iohexol, Iodixanol and Allergy
Abstract
Background: Contrast-induced nephropathy, a complication associated with intravenous pyelography (IVP), is a recognized concern. However, the relative nephrotoxic potential of the iso-osmolar non-iodinated contrast medium (iodixanol) versus the low-osmolar contrast medium (iohexol) remains unclear. This single-center, Randomized Control studies involved 58 patients undergoing IVP, who were randomly assigned to receive either iodixanol or iohexol.
Materials: 58 patients with high risk for contrast-induced nephropathy, consisted of 25 (43.10%) patients with renal insufficiency an d 16 (27.58%) with diabetes mellitus. The study assessed the nephrotoxic effects (contrast nephropathy) and the profiles of complement and cytokines between the two groups. The average contrast medium volume administered during each IVP procedure was 0.8 mL/kg.
Results: The overall incidence of contrast nephropathy was 04%, with one case in each group. No significant differences were observed in the rates of contrast nephropathy or allergic reactions between the iodixanol and iohexol groups. Additionally, there was no notable difference in cytokine 89% profiles. The overall incidence of allergic reactions was 17.24%. Early allergic reactions occurred in 03/29 (10.34%) of the Iohexol group patients and none in the Iodixanol group of patients. Late allergic reactions occurred in 03/29 (10.34%) of the Iohexol group and 02/29 (06.89%) of the Iodixanol group of patients (p = 0.001). One patient developed a severe skin rash due to a late adverse reaction following iodixanol administration. No fatalities were reported. Both iodixanol and iohexol are considered safe for routine IVP examinations, exhibiting a low nephrotoxicity profile, particularly in elderly or high-risk patients.
Conclusions: In conclusion, iodixanol and iohexol contrast media for routine IVP examinations are safe and have a low nephrotoxicity profile, particularly in elderly and high-risk patients. Late allergic reactions may be the most common adverse effect following the infusion of nonionic contrast media.
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Dr. Jose Kuruvilla
Associate Professor of Radio Diagnosis, Department of Radio Diagnosis, Al Azhar Medical College and Superspeciality Hospital, Thodupuzha, Kerala
Dr. Daisy Joseph
Professor of Radio Diagnosis, Department of Radio Diagnosis, Al Azhar Medical College and Superspeciality Hospital, Thodupuzha, Kerala
Dr. Sancy Mary Sam
Associate Professor of Radio Diagnosis, Department of Radio Diagnosis, Al Azhar Medical College and Superspeciality Hospital, Thodupuzha, Kerala.