Comparison of nephrotoxicity between two gadolinium-contrasts, gadodiamide and gadopentetate in patients with mildly diminished renal failure

• Published in: Journal of toxicological sciences Vol. 42; no. 3; pp. 379 - 384
• Main Authors: Naito, Shokichi, Tazaki, Hiromi, Okamoto, Tomoko, Takeuchi, Kazuhiro, Kan, Shinichi, Takeuchi, Yasuo, Kamata, Kouju
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Toxicology 2017; Japan Science and Technology Agency
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers - blood; Brain; Brain - diagnostic imaging; Chronic Kidney Disease (CKD); Contrast media; Contrast Media - administration & dosage; Contrast Media - toxicity; Creatinine; Creatinine - blood; Cystatin C - blood; Epidermal growth factor receptors; Female; Gadodiamide; Gadolinium; Gadolinium - administration & dosage; Gadolinium - toxicity; Gadolinium DTPA - administration & dosage; Gadolinium DTPA - toxicity; Gadolinium-Contrast medium; Gadopentetate; Gadopentetate dimeglumine; Glomerular Filtration Rate; Health risk assessment; Humans; Kidney Function Tests; Kidney transplantation; Magnetic Resonance Imaging; Male; Middle Aged; Nephrotoxicity; Neuroimaging; NMR; Nuclear magnetic resonance; Patients; Prospective Studies; Randomization; Rank tests; Renal failure; Renal function; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - physiopathology; Weighing; Young Adult; Chronic Kidney Disease (CKD); Gadodiamide; Gadolinium-Contrast medium; Gadopentetate; Nephrotoxicity
• ISSN: 0388-1350; 1880-3989
• DOI: 10.2131/jts.42.379

Although gadolinium (Gd)-based contrast media have been found to be nephrotoxic, their nephrotoxicity, and the dependence of nephrotoxicity on chelate types, have not been assessed in patients with normal or mildly diminished renal failure. This prospective, randomized study compared the nephrotoxicity of low doses of the nonionic Gd-based contrast medium gadodiamide (Omniscan®) and the ionic Gd-based contrast medium gadopentetate (Magnevist®) in patients with serum creatinine < 1.6 mg/dL. Patients aged 20 to 80 years, weighing 45 to 70 kg and with normal or < 1.6 mg/dL Serum-creatinine in the 3 months prior to undergoing magnetic resonance imaging (MRI) of brain, were enrolled. Patients were randomized to receive 0.1 mol/kg gadodiamide or gadopentetate. Serum-creatinine, serum cystatin-C, estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula, and estimated creatinine clearance rate (eCCr) using the Cockcroft-Gault formula were measured just before and 16-80 hr after MRI. Groups were compared statistically by Mann-Whitney U-tests and Wilcoxon signed-rank tests. There were no significant differences in clinical characteristics between the gadodiamide (n = 43) and gadopentetate (n = 59) groups. Serum-creatinine, eGFR and eCCr before and 16-80 hr after MRI did not differ significantly within either group or between the two groups. Serum cystatin-C was significantly higher 16-80 hr after than before MRI only in the gadodiamide group (0.79 ± 0.21 vs. 0.74 ± 0.14 mg/L, p = 0.028). The ionic contrast medium, gadopentetate, did not affect renal function during MRI, whereas the nonionic contrast medium, gadodiamide, affected renal function transiently.