Reply to letter to the editor re: Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?
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No, nephrotoxicity from intravenous contrast media is much ado about risk stratification!
We thank Dr. Stratta et al. for commenting on our article, “Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?”, and would briefly like to discuss their counterarguments to this question and their statement that intravenous (IV) contrast media (CM) administration has a “negligible clinical impact” in an outpatient population.
First of all, we agree with Dr. Stratta et al. that the apparent higher rates of acute kidney injury (AKI) from intra-arterial (IA) CM injections may be explained by other causes than CM-induced nephropathy (CIN), e.g. cholesterol embolisation from catheter manipulations. A true difference in clinical risk factors between patients needing an IA coronary procedure and those requiring an IV CM injection for a routine computed tomography (CT) may also play a significant role. The lower rate of CIN in many literature...
KeywordsChronic Kidney Disease Contrast Medium Digital Subtraction Angiography Acute Kidney Injury Abdominal Aortic Aneurysm
All authors have received fees from pharmaceutical companies when lecturing about contrast media. T.A. is receiving royalty for iodixanol from GE Healthcare.