Comparison between gadolinium and iodine contrast for percutaneous intervention in atherosclerotic renal artery stenosis: clinical outcomes

Abstract

Percutaneous angiography with iodinated contrast in patients with chronic kidney disease carries a risk of contrast nephropathy, which is independently associated with increased mortality. Gadolinium contrast is a potential safe alternative to iodinated contrast for percutaneous transluminal renal angioplasty (PTRA).

We compared the outcomes in patients with serum creatinine (Cr) >/= 176 micromol/L (2 mg/dL), who had either gadolinium (n = 57), iodinated (n = 68) or a combination of gadolinium and iodinated-contrast-enhanced (n = 38) PTRA. All patients had similar degrees of pre-procedural renal insufficiency.

According to our results, gadolinium contrast is (when compared to iodinated contrast) associated with a significantly lower incidence of contrast nephropathy and early progression to end-stage renal disease (ESRD) in patients with pre-existing chronic kidney disease. The risk of fibrosing dermopathy remains to be established.