Iodixanol and iopamidol carry a similar risk of contrast-induced nephrotoxicity in patients with chronic kidney disease and diabetes mellitus undergoing coronary angiography, researchers report in the American Heart Journal for November.

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However, lead investigator Dr. Warren Laskey told Reuters Health, “Although our study failed to find a difference between iodixanol and iopamidol in an indirect measure of renal injury, the larger, and more clinically relevant, question remains unanswered: Does altering the risk of nephropathy with a specific contrast medium alter the risk of adverse clinical events following an angiographic procedure?”

To examine the first question, the potential nephrotoxicity of these agents, Dr. Laskey of the University of New Mexico, Albuquerque and colleagues randomized 526 patients with chronic kidney disease and diabetes to receive iodixanol or iopamidol during angiography.

In 418 evaluable subjects, the median peak increase in serum creatinine between baseline and 3 days after the procedure was 0.10 mg/dL with iodixanol and 0.09 mg/dL with iopamidol. Corresponding rates of nephrotoxicity were 11.2% and 9.8%.

Overall, say the investigators, “it may well be that there is no true difference in nephrotoxicity between iodixanol and iopamidol, or, if there is, such a difference is unlikely to be clinically meaningful.”