European Radiology

, Volume 23, Issue 5, pp 1264–1265 | Cite as

Reply to letter to the editor re: Are intravenous injections of contrast media really less nephrotoxic than intra-arterial injections?

  • Ulf NymanEmail author
  • Torsten Almén
  • Bo Jacobsson
  • Peter Aspelin
Contrast Media

Dear Editor,

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...


Chronic Kidney Disease Contrast Medium Digital Subtraction Angiography Acute Kidney Injury Abdominal Aortic Aneurysm 
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All authors have received fees from pharmaceutical companies when lecturing about contrast media. T.A. is receiving royalty for iodixanol from GE Healthcare.


  1. 1.
    From AM, Bartholmai BJ, Williams AW, Cha SS, McDonald FS (2008) Mortality associated with nephropathy after radiographic contrast exposure. Mayo Clin Proc 83:1095–1100PubMedCrossRefGoogle Scholar
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    Karlsberg RP, Dohad SY, Sheng R (2011) Contrast medium-induced acute kidney injury: comparison of intravenous and intraarterial administration of iodinated contrast medium. J Vasc Interv Radiol 22:1159–1165PubMedCrossRefGoogle Scholar
  3. 3.
    Nyman U (2011) Minimizing contrast-induced nephropathy. Strategies in CTA, catheter angiography and interventions (in German, English version online). Gefässchirurgie 16:469–480CrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Ulf Nyman
    • 1
    Email author
  • Torsten Almén
    • 2
  • Bo Jacobsson
    • 3
  • Peter Aspelin
    • 4
  1. 1.Department of Diagnostic RadiologyUniversity of LundTrelleborgSweden
  2. 2.Department of Clinical Sciences/Medical RadiologyUniversity of Lund, Skåne University HospitalMalmöSweden
  3. 3.Department of Diagnostic Radiology, The Queen Silvia Children’s HospitalUniversity of Gothenburg and the Sahlgrenska AcademyGöteborgSweden
  4. 4.Division of Medical Imaging and Technology, Department of Clinical ScienceIntervention and Technology (CLINTEC), Karolinska Institute and University HospitalStockholmSweden

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