Iso-osmolar contrast medium better preserves short- and long-term renal function after cardiovascular catheterizations in patients with severe baseline renal insufficiency

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) ≥ 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.