European Radiology

, Volume 16, Issue 12, pp 2712–2720 | Cite as

Gadolinium contrast media are more nephrotoxic than iodine media. The importance of osmolality in direct renal artery injections

  • Barbara ElmståhlEmail author
  • Ulf Nyman
  • Peter Leander
  • Chun-Ming Chai
  • Klaes Golman
  • Jonas Björk
  • Torsten Almén
Contrast Media


A study was undertaken of the role of osmotoxicity in gadolinium (Gd) and iodine contrast media (CM) nephrotoxicity in ischemic porcine kidneys. Test solutions: mannitol iso-osmotic to 0.5 M gadopentetate (1.96 Osm/kg H2O), 0.5 M gadodiamide (0.78 Osm/kg H2O) and 0.5 M iohexol (190 mg I/ml, 0.42 Osm/kg H2O). Each solution was injected [3 ml/kg body weight (BW)] into the balloon-occluded (10 min) renal artery of eight left-sided nephrectomized pigs. The plasma half-life of a glomerular filtration rate (GFR) marker was used to compare their effects on GFR 1–3 h post-injection. The median half-lives of the GFR marker after injection of gadopentetate (1,730 min) and mannitol 1.96 Osm/kg H2O (2,782 min) did not differ statistically (P=0.28), but were significantly longer than after all other solutions (P<0.001). There was no significant difference (P=0.06) between gadodiamide (218 min) and mannitol 0.82 Osm/kg H2O (169 min), while there was (P=0.03) between iohexol (181 min) and mannitol 0.43 Osm/kg H2O (148 min). The difference between gadodiamide and iohexol was significant (P=0.01). Reduction in GFR, as a marker of nephrotoxicity, induced by gadopentetate correlated with its high osmolality, while the effect of gadodiamide and iohexol may include chemotoxicity. Iohexol molecules were less nephrotoxic than the Gd-CM molecules and contain three-times the number of attenuating atoms per molecule.


Angiography Computed tomography Contrast media Osmolality Renal impairment Gadolinium 



This study was financed in part by GE Healthcare.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Barbara Elmståhl
    • 1
    Email author
  • Ulf Nyman
    • 2
  • Peter Leander
    • 1
  • Chun-Ming Chai
    • 3
  • Klaes Golman
    • 4
  • Jonas Björk
    • 5
  • Torsten Almén
    • 1
  1. 1.Department of Diagnostic RadiologyMalmö University Hospital, Lund UniversityMalmöSweden
  2. 2.Department of RadiologyLasarettet TrelleborgTrelleborgSweden
  3. 3.Department of Experimental ResearchMalmö University Hospital, Lund UniversityMalmöSweden
  4. 4.GE HealthBiosciencesMalmöSweden
  5. 5.Competence Center for Clinical ResearchUniversity Hospital, Lund UniversityLundSweden

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