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PubMed1997

Estimation of glomerular filtration rate in normal sheep by the disappearance of iohexol from serum.

The aim of the study was to establish reference values for glomerular filtration rate (GFR) in healthy sheep from the clearance of iohexol in serum. Fifteen healthy sheep were tested twice with 14 to 21 days between tests. No side-effects were observed after iohexol injections and all the sheep were clinically normal during and after the study. The mean clearance of iohexol estimated by the two-compartment method was 1.8 ml/min per kg (95% CI = 1.6-2.0) in the first trial and 1.7 ml/min per kg (1.5-1.9) in the second trial. The mean GFRiohexol estimated by a one-compartment method was 1.9 ml/min per kg (1.7-2.2) in the first trial and 1.8 ml/min per kg (1.6-2.0) in the second. The GFR values were similar to those reported for the inulin method. The results indicate that the iohexol method is valid for estimating GFR in sheep, and it is easier to perform than the inulin method.

Animals↗
PubMed1995

Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a randomized trial. The Iohexol Cooperative Study.

The incidence of nephrotoxicity occurring with the nonionic contrast agent, iohexol, and the ionic contrast agent, meglumine/sodium diatrizoate, was compared in 1196 patients undergoing cardiac angiography in a prospective, randomized, double-blind multicenter trial. Patients were stratified into four groups: renal insufficiency (RI), diabetes mellitus (DM) both absent (N = 364); RI absent, DM present (N = 318); RI present, DM absent (N = 298); and RI and DM both present (N = 216). Serum creatinine levels were measured at -18 to 24, 0, and 24, 48, and 72 hours following contrast administration. Prophylactic hydration was administered pre- and post-angiography. Acute nephrotoxicity (increase in serum creatinine of > or = 1 mg/dl 48 to 72 hours post-contrast) was observed in 42 (7%) patients receiving diatrizoate compared to 19 (3%) patients receiving iohexol, P < 0.002. Differences in nephrotoxicity between the two contrast groups were confined to patients with RI alone or combined with DM. In a multivariate analysis, baseline serum creatinine, male gender, DM, volume of contrast agent, and RI were independently related to the risk of nephrotoxicity. Patients with RI receiving diatrizoate were 3.3 times as likely to develop acute nephrotoxicity compared to those receiving iohexol. Clinically severe adverse renal events were uncommon (N = 15) and did not differ in incidence between contrast groups (iohexol N = 6; diatrizoate N = 9). In conclusion, in patients undergoing cardiac angiography, only those with pre-existing RI alone or combined with DM are at higher risk for acute contrast nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed2001

Iohexol as a marker of glomerular filtration rate in patients with diabetes: comparison of multiple and simplified sampling protocols.

AIMS: To report on the reproducibility of iohexol glomerular filtration rate (GFR) estimation, to compare the plasma clearance of iohexol with that of[51Cr]EDTA and to evaluate the reliability of reduced sampling schedules in estimating GFR in Type 1 and Type 2 diabetes mellitus. METHODS: Agreement was assessed in 15 Type 1 and 26 Type 2 diabetics with creatinine ranging from 53 to 564 micromol/l. RESULTS: The regression between multiple-sample iohexol and[51Cr]EDTA clearances was 0.999 in Type 1 and 0.987 in Type 2 diabetes (P < 0.0001 for both). A seven-sample design and the three-sample approach by Brøchner-Mortensen were validated by comparison with the full-sample schedule in 87 patients (51 Type 1, 36 Type 2). Full-sample GFR was 80.3 +/- 43.8, seven-sample 79.5 +/- 43.9 (r = 0.990) and three-sample 79.8 +/- 45.2 ml.min-1.1.73 m-2 (r = 0.972). The coefficients of variation of GFR were 2.7 +/- 1.4% and 3.8 +/- 1.9% for the full-sample and the seven-sample approaches, respectively, and significantly higher for the three-sample design (6.9 +/- 3.4%, P = 0.0001). CONCLUSIONS: After iohexol injection, the Brøchner-Mortensen schedule does not provide an accurate estimate of GFR. The seven-sample approach gives acceptable errors and allows a good estimate of GFR throughout a wide range of renal function.

Adult↗
PubMed1999

Comparison of different doses of iohexol with amidotrizoate for excretory urography in cats.

In five cats with normal renal function, doses of 200, 400, 600 and 800 mg iodine kg(-1)bodyweight of iohexol (350 mg iodine ml(-1)) were assessed in comparison to a dose of 880 mg iodine kg(-1)bodyweight of meglumine-sodium amidotrizoate (370 mg iodine ml(-1)) to determine the smallest dose which produces diagnostically adequate results for excretory urography. Urographic quality, haematologic and biochemical parameters, urinalysis and urinary osmolality, pulse and respiratory rates, blood pressure and adverse effects were determined. Iohexol presented fewer adverse reactions and influenced blood pressure less than amidotrizoate. The smallest dose of iohexol which provided urograms of similar quality to amidotrizoate was 400 mg iodine kg(-1)bodyweight. This study suggests that iohexol is safer and produces urograms of better quality than amidotrizoate.

Animals↗
PubMed1997

An iodinated lipid emulsion for CT of the liver. Comparison with iohexol in the detection of experimental hepatic metastases.

PURPOSE: The iodinated hepatocyte-specific lipid emulsion FP 736-03 for CT of the liver was tested against the conventional water-soluble contrast agent iohexol. MATERIAL AND METHODS: A nude rat model of experimental multiple hepatic metastases from a human colonic cancer was used. The animals were examined 3 weeks after intraportal tumor cell injection. Native examination, and iohexol- and FP-736-03-enhanced CT were performed. The detection rate was determined on a lesion-by-lesion basis. Metastatic diameters measured on CT images were compared with corresponding macroscopic serial liver specimens. RESULTS: In a lesion-by-lesion analysis of 140 metastases, the detection rates for 2 viewers were 16.4% and 30.7% for native examination, 12.9% and 17.9% for iohexol-enhanced CT, and 53.6% and 72.1% for FP-736-03-enhanced CT, respectively. The detection rates tended to increase with lesion diameter. CONCLUSION: The hepatocyte-specific contrast medium FP 736-03 improved the detection rate significantly in comparison with both native and iohexol-enhanced CT.

Animals↗
PubMedDate not supplied

Iohexol in patients with previous adverse reactions to contrast media.

Iohexol (Omnipaque) was used for enhancement of brain CT in 17 patients with previous adverse reactions to contrast media. Two of these patients also had cerebral angiography using iohexol. No premedication was given. The only adverse reaction was a skin reaction 24 hours after the iohexol injection, which might have been induced by the contrast medium or treatment with antibiotics. Five of the patients had repeated iohexol injections at different occasions without adverse reactions.

Adolescent↗
PubMedDate not supplied

Iohexol vs. metrizamide in studies of glucose metabolism. A survey.

Nonionic contrast media represent a significant advance for myelography due to their substantially lower neurotoxicity. Some side effects have been noted with metrizamide, however. Origins of adverse effects have not been clearly defined. Studies reviewed here investigated the effects of two nonionic contrast media, metrizamide and iohexol, on glucose metabolism in neural tissue cells in vitro using rat hippocampal tissue slices. Isotonic metrizamide produced metabolic disturbances that may partially explain some clinical adverse effects. It was hypothesized that iohexol, which, unlike metrizamide, does not contain a 2-deoxy-D-glucose component, would not have this effect. A series of in vitro experiments compared the two media. Results showed no evidence that iohexol caused metabolic disturbances, but in vitro there was a depressive effect on metabolism from hypertonicity. In vivo water will rapidly diffuse toward hypertonic areas, thus neutralizing the osmotic effect. The lesser metabolic effect suggests that iohexol would be safer than metrizamide for subarachnoid examinations.

Animals↗
PubMedDate not supplied

Iohexol vs. iopamidol for myelography.

Three hundred sixty-three patients undergoing myelography were examined on a random basis with either iohexol (179) or iopamidol (184). All patients underwent neurologic or psychological assessment before and after the examination; 100 patients also submitted to cardiovascular and hematologic tests. Sixty patients were examined with electroencephalography before and after myelography. Incidence and severity of side effects were carefully evaluated in all patients and, wherever possible, by an independent observer, who was not told which contrast medium had been used. Radiographic quality was independently estimated and graded and was equally adequate with both media. Both iohexol and iopamidol will, in competent hands, provide myelograms of good radiographic quality without producing any permanent adverse sequelae. Incidence and severity of adverse side effects were slightly but significantly less with iohexol than with iopamidol. Three patients of the 25 examined with iopamidol showed EEG evidence of neuronal excitability following myelography. None of the 35 examined with iohexol showed this change.

Adolescent↗
PubMedDate not supplied

Iohexol in phlebography of the leg. A comparative investigation with meglumine metrizoate.

Comparing iohexol 240 mg I/ml, iohexol 300 mg I/ml and meglumine-Ca metrizoate 200 mg I/ml in phlebography of the leg in patients on or without anticoagulants, no sign of postphlebographic thrombosis was found using the 125I-fibrinogen uptake test and repeat phlebography. More adverse reactions occurred with metrizoate than with iohexol. Metrizoate provided significantly poorer demonstration than the two iohexol concentrations with higher iodine content.

Adult↗
PubMed1986

Penetration of subarachnoid contrast medium into rabbit spinal cord. Comparison between metrizamide and iohexol.

The penetration into rabbit spinal cord of two nonionic contrast media, iohexol and metrizamide, and a reference tracer, technetium DTPA, were compared. The spinal subarachnoid space was perfused for 4 hours with a CSF solution to which technetium DTPA and either iohexol or metrizamide had been added. The contrast media and technetium DTPA concentrations reached a plateau level in CSF outflow within 80 minutes. The contrast media concentrations in CSF were higher than the technetium DTPA (P less than .001). In the cord tissue, technetium DTPA reached higher concentrations than the contrast media (P less than .001), and iohexol reached higher concentrations relative to technetium DTPA than metrizamide (P less than .001). The mean contrast media distribution volumes in the thoracic cord were 13% (iohexol) and 12% (metrizamide). The smaller distribution volume observed for metrizamide could be related to the larger effective size of "associated" metrizamide molecules or an interference with diffusion perhaps related to binding to glucose carriers.

Animals↗
PubMed1988

Iohexol inhibits adenylate cyclase.

Previous studies demonstrated that the intravenous administration of the ionic radiographic contrast agent, diatrizoate, and the nonionic agent, iohexol, causes a decrease in the rate of cerebrospinal fluid (CSF) production. Evidence suggests that adrenergic-mediated adenylate cyclase (AC) activity controls CSF production. Diatrizoate was found to inhibit AC activity. The authors now report that iohexol inhibits activity of this enzyme. Adenylate cyclase activity was measured in membrane fractions of bovine choroid plexus in the presence of various concentrations of iohexol. A concentration-dependent inhibition of basal and adrenergic-stimulated AC activity by the contrast agent was observed. The concentration of iohexol that produced a 50% inhibition was about 2.3 mM. This is similar to the concentration of diatrizoate that produced equivalent enzyme inhibition. These results support the contention that one mechanism for the action of contrast media in reducing CSF production involves inhibition of AC activity.

Adenylyl Cyclase Inhibitors↗
PubMed1988

Functional and morphologic effects of ioxilan, iohexol, and diatrizoate on endothelial cells.

The effects of a new contrast agent, ioxilan, on vascular endothelium were compared with those of iohexol and diatrizoate. Rabbit aortic rings were incubated in contrast medium (CM) (350 mgI/mL) or Krebs solution as a control agent, for 5 minutes. Scanning and transmission electron micrographs showed that iohexol and ioxilan produced irregularities in the cell borders and in some vesicles, whereas diatrizoate produced intercellular gaps and numerous vesicles containing myelin figures. The ability of the endothelial cells to release endothelium-derived relaxing factor was tested by measuring the dilator response to acetylcholine. Incubation of aortic rings in CM for 5 minutes caused no changes in responses. However, 15-minute contact with diatrizoate irreversibly reduced the dilator response to 49%, and contact with sucrose (2100 mOsm/kg) reduced it to 9%. After incubation for 60 minutes, iohexol reduced the dilator response to 43%, while ioxilan caused no change. Since the hydrophilicity of the nonionic compounds, ioxilan and iohexol, is similar, while ioxilan's osmolality is substantially lower, the endothelial changes detected by electron microscopy and induced by the CM are attributable to their chemical properties, whereas the loss of dilator response appears to be mediated by high osmolality.

Animals↗
PubMed1989

A comparison of the systemic responses to rapid intravenous injections of ioxilan, iohexol, and diatrizoate in rabbits.

Rapid intravenous injections of contrast media are used for angiocardiography, intravenous digital subtraction angiography (DSA), and rapid scan computed tomography procedures. These rapid intravenous injections have been shown to produce significant hemodynamic changes that appear related to contrast media osmolality. In this study the systemic responses to 2-second injections at a dose of 1.5 mL/kg were compared for a new nonionic agent, ioxilan (350 mgI/mL), and for iohexol (350 mgI/mL), meglumine/sodium diatrizoate (370 mgI/mL), and saline. Ioxilan has a lower osmolality and viscosity than iohexol and is formulated with a 3 mM sodium citrate as a buffer and anticoagulant. All of the test solutions produced statistically significant changes in arterial pressure and respiratory rate (P less than .05, Student's t-test). The decrease in arterial pressure seen with diatrizoate (20.1%) was significantly greater than the decrease seen with either ioxilan (10.2%) or iohexol (10.2%). All of the responses observed were transient and would not be of clinical concern in a healthy patient. Ioxilan, which contains the calcium binding agent, sodium citrate, and iohexol appear to cause less systemic effects then diatrizoate.

Animals↗
PubMed1991

Estimation of glomerular filtration rate from low-dose injection of iohexol and a single blood sample.

Clearance of a small dose of iohexol (7 g I) was compared with the glomerular filtration rate (GFR) marker 51Cr EDTA in 11 healthy volunteers. The two tracers were injected simultaneously. The plasma concentration of iohexol was measured with x-ray fluorescence technique. Glomerular filtration rate was determined using blood samples drawn three and four hours after injection. An excellent correlation (0.92 less than r less than 0.97) between iohexol clearance and 51Cr EDTA clearance was found. Glomerular filtration rate can be reliably determined with a low dose of iohexol and a single blood sample obtained three hours after the injection in persons with normal serum creatinine. This new method is a good alternative to the methods using radiopharmaceuticals; it causes no radioactive burden to the patients, increases patient comfort, reduces costs, and requires no special license.

Adult↗
PubMed1994

Myocardial capillary permeability to iohexol. Evaluation with fast x-ray computed tomography.

RATIONALE AND OBJECTIVES: The accuracy and sensitivity of fast x-ray computed tomography (CT) for estimating myocardial capillary permeability to iohexol was evaluated. The long-term goal is to quantitate capillary integrity. METHODS: Anesthetized pigs were scanned during coronary infusion of adenosine and an aortic root injection of iohexol. The CT images were used to compute myocardial perfusion (F) and capillary extraction factor (E). The permeability-surface area product (PS) was calculated as follows: PS = -F.ln(1-E). Accuracy of the PS value was evaluated with catheter-sampled dual-dilution curves (DDC) resulting from simultaneous injection of cobalt-58 EDTA and iodine-125 albumin. A second group of pigs was scanned while bradykinin (5, 10 or 20 ng/kg/min) was infused into the coronary artery. RESULTS: The DDC and CT-based PS values (mean +/- standard deviation) were as follows: 0.149 +/- 0.107, 0.125 +/- .067; 0.127 +/- 0.072, 0.129 +/- 0.053; and 0.132 +/- 0.043, 0.190 +/- 0.111 for 350, 230, and 175 mg iodine/mL, iohexol respectively. The regression was PS = 0.22 [bradykinin] + 0.083, r = .845. CONCLUSIONS: Dual-dilution curve-obtained and CT-obtained PS values are well correlated. The data show that concentration of iohexol has little (P > .1) impact on the calculated PS value and the bradykinin data suggest good sensitivity.

Adenosine↗
PubMed1995

Animal experimental myelography in the pig. A comparison between iohexol and iotrolan.

RATIONALE AND OBJECTIVES: The authors compared the effects of a nonionic monomeric, iohexol (Omnipaque, 300 mg I/ml), and a nonionic dimeric, iotrolan (Isovist, 300 mg I/ml), contrast medium in the spinal subarachnoid space of the pig. METHODS: Lumbar and lateral C1-C2 punctures were performed in 10 pigs. Ten milliliters iohexol or iotrolan were injected via the lumbar needle. Blood pressure, electrocardiogram, intravesical pressure, and cerebrospinal fluid pressure were recorded during the injections and at intervals for 4 to 5 hours after the injections. Blood samples were taken at 30, 60, 120, 180, 240, and 300 minutes after the injections and analyzed for iodine concentration. RESULTS: No changes were seen during the injections, and there were no differences in the blood pressure, cerebrospinal fluid pressure, electrocardiographic recordings, or in the plasma iodine concentrations during the first 4 to 5 hours after the injections. Short-lasting, rhythmic bladder contractions were seen during some injections with both iohexol and iotrolan. CONCLUSION: Both iohexol and iotrolan were well tolerated, and there was no significant difference between them. and there was no significant difference between them.

Animals↗
PubMed1995

Plasma levels and urinary excretion of iodine after oral administration of iohexol in dogs and cats.

RATIONALE AND OBJECTIVES: Plasma and urinary iodine concentrations were assessed after oral administration of iohexol in five dogs and five cats. MATERIALS AND METHODS: Ventrodorsal and right lateral radiographs were taken; a 3-mL blood sample was collected 30 minutes and 1, 2, 4, and 6 hours after dose in each animal; and the bladder was emptied at 2 and 6 hours in dogs and at 6 hours in cats after oral administration of 700 mg I/kg iohexol (300 mg I/mL). Iodine concentration was measured using a sequential inductively coupled plasma atomic emission spectrometer system. RESULTS: Peak concentrations of plasma iodine were detected in samples taken from both dogs (0.33 mg I/mL) and cats (0.28 mg I/mL) 30 minutes after iohexol administration, with a gradual decline at 1, 2, 4, and 6 hours. Total urinary excretion during the 6 hours after the administration does of iohexol was higher (4.3%) in cats than in dogs (2.0%). In each species, there was a relationship between gastrointestinal motility observed radiographically and the subsequent excretion of iodine in the urine. CONCLUSIONS: Results indicate that approximately 2% of the oral dose is absorbed and excreted in the urine of dogs within 6 hours, and approximately 4% of the dose is absorbed and excreted in cats.

Administration, Oral↗
PubMed2002

Nonionic contrast media iohexol and iomeprol decrease renal arterial tone: comparative studies on human and porcine isolated vascular segments.

RATIONALE AND OBJECTIVES: The vasoconstriction of the renal arteries is frequently considered as a crucial factor for radiocontrast-induced nephropathy. A direct effect of iodinated radiographic contrast medium (RCM) on vascular smooth muscle is supposed to be one component of the vascular response. We studied the effect of the nonionic RCM iomeprol and iohexol on the tonus of isolated human and porcine renal arteries in vitro. METHODS: In an organ bath renal arterial rings, uncontracted or precontracted by 10 micromol/L phenylephrine were incubated with increasing concentrations (15-103 mg iodine/mL) of iohexol, iomeprol, and mannitol solution isoosmolar to the contrast media. In a part of the preparations the endothelium was destroyed. Human vessels were obtained from tumor nephrectomy specimens of 10 patients. RESULTS: In human experiments iomeprol and iohexol (P < 0.05) relaxed renal arterial rings whereas mannitol produced concentration-dependent contractions. The relaxation by both contrast media was slightly attenuated upon increasing their concentration. The differences between mannitol solutions and RCM were statistically significant (P < 0.001) at concentrations of 57 mg iodine/mL and higher. Precontracted rings were significantly stronger relaxed by the RCM compared with mannitol (P < 0.001). The contrast medium induced relaxation did not depend on the presence of an intact endothelium (P > 0.05). Experiments with renal arterial segments prepared from swine showed similar results, with stronger relaxations than the human preparations. CONCLUSION: Iomeprol and iohexol relaxed isolated renal arterial segments. These observations are in contradiction with the hypothesis that contrast media induce nephropathy by a direct vasoconstrictive effect on vascular smooth muscle. They do not exclude, however, a reduction of renal blood flow by other factors like liberation of hormones.

Animals↗