J. ROBERT EVANS, M.D.; STEWART W. SHANKEL, M.D.; RALPH E. CUTLER, M.D.
EVANS JR, SHANKEL SW, CUTLER RE. Low Osmolar Contrast Agents and Nephrotoxicity. Ann Intern Med. 1987;107:116. doi: 10.7326/0003-4819-107-1-116_1
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Published: Ann Intern Med. 1987;107(1):116.
To the editor: New intravascular radiographic contrast agents, iopamidol, iohexol, and ioxaglate all have lower osmolality than do older agents (1). Several authors have claimed that the low osmolar contrast agents are less toxic to the kidneys than are the older agents (1, 2). However, we observed three episodes of decreasing renal function closely associated with the use of two of the new agents. All three patients had diabetes mellitus, fundiscopic evidence of diabetic retinopathy, and renal insufficiency before coronary angiography was done.
A 65-year-old woman was hospitalized with acute myocardial infarction. Both a history and physical examination showed diffuse
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