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Kidney Week

Abstract: SA-PO530

Are the Iodinated Contrast Media Dangerous? Influence of Iodinated Contrast Media on Renal and Thyroid Gland in Patients with CKD

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Brodowska-Kania, Dorota, MIlitary Intitiute of Medicine, Warsaw, Poland
  • Niemczyk, Stanislaw, Military Medical Institute of Warsaw, Warsaw, Poland
Background

The aim of our study was to assess the risk and incidence of CIN in patients with CKD, the impact of iodine CM on the endocrine function of the thyroid gland and the impact of renal impairment on the risk of contrast-induced hypothyroidism or hyperthyroidism.

Methods

We included 75 patients(pts). The first CKD-Group: 36pts with eGFR<60ml/min. (mean age 69.4±11, male-72.2%). The second RRT-Group: 20pts chronically dialysed (mean age 63.7±12.2, male-50%). The control group: 19pts with eGFR>60 ml/min, (mean age 48.2±18.0, male-57.9%). CIN prevention were conducted among all patients: hydration and N-acetylocysteine. All patients received iomeprol or iohexol. Patients were monitored for 6 months after the administration of CM (48 hours, 14 days and 6 months after contrast administration). Creatinine, urea, eGFR, cystatin C, TSH, free-T3(fT3), free-T4(fT4), reverse-T3(rT3), were monitored. The results were statistically analyzed. Study was approved by the Ethics Committee.

Results

AKI was found in 2.7% in test group (3 pts). In the CKD group, the mean creatinine was 1.65mg / dl (1.33-2.28), eGFR 39.91 ± 12.89, cystatin C 2.17mg / dl ± 0.83, urea 67.7mg / dl ± 27.55. Increase in creatinine value was not statistically significant (ΔCREA 0.2 p = 0.8, Δcystatin C-0.04, p = 0.891, and ΔeGFR = 0.62, p = 0.912 within 48 hours after administration of CM.
In the CKD group two weeks after administration of CM a decrease fT3, ΔfT31CKD -0.39 ± 0.77 p1CKD = 0.004. changes fT3 persisted during the 6 months follow-up (ΔfT32CKD = -0.36 ± 0.91 p2CKD = 0.023). The changes of ΔfT3 were no correlation with dose of CM and eGFR.In the group of RRT a change of ΔfT41RRT 1.58 ± 2.56 p1RRT = 0.013 was observed after 2 weeks, which maintained for 6 months (ΔfT42RRT 2.0 ± 3.38 p2RRT = 0.016).
In the control group the changes were minimal and not statistically significant. No thyroid dysfunction was observed.

Conclusion

Adverse effects of intravenous administration of iodine contrast are rare. CIN in the group with CKD is 2.7%. CM have no adverse effect on kidney and thyroid function among patients with good function of these organs. CKD is not a risk factor for contrast-induced hyperthyroidism or hypothyroidism. Changes in thyroid hormones were statistically significant but asymptomatic. CM are not so dangerous. Further research is needed.