Does intravenous contrast medium administration result in altered renal biomarkers? A study in clinically stable cats with and without azotemia

J Feline Med Surg. 2022 Jun;24(6):565-579. doi: 10.1177/1098612X211038535. Epub 2021 Sep 8.

Abstract

Objectives: The aim of this study was to determine the prevalence of post-contrast acute kidney injury or comparable side effects on kidney function in cats receiving the non-ionic, iodinated agent ioversol and/or paramagnetic agent gadoteric acid.

Methods: Fifty-two animals were divided into four groups on the basis of contrast medium administration for imaging: ioversol (n = 27), gadoteric acid (n = 12), dual contrast media (n = 4) or control, which received an infusion of isotone intravenous fluids only during anaesthesia (n = 9). Blood and urine samples were obtained three times after contrast administration and compared with values obtained prior to administration of the contrast medium. Creatinine (<1.60 mg/dl), symmetric dimethylarginine (SDMA; ⩽14 μg/dl), urine protein:creatinine ratio (UPC; <0.2) and critical differences for creatinine (<0.3 mg/dl) and SDMA (<5.98 μg/dl) were measured.

Results: No significant short-term effects on mean creatinine, SDMA and UPC measurements were seen. Borderline proteinuria (UPC, 0.2-0.4) was detected in 11.4% of cases after contrast media administration. A UPC of more than 0.2 in five cases indicated that contrast media may affect kidney function, leading to (transient) proteinuria.

Conclusions and relevance: This study found no side effect on renal function following the administration of ioversol or gadoteric acid, provided patients were adequately hydrated. However, the clinical relevance of proteinuria in some cats needs to be evaluated in future studies.

Keywords: Contrast media; SDMA; creatinine; kidney; renal failure.

MeSH terms

  • Acute Kidney Injury* / veterinary
  • Animals
  • Azotemia* / chemically induced
  • Azotemia* / veterinary
  • Biomarkers
  • Cat Diseases* / chemically induced
  • Cats
  • Contrast Media / adverse effects
  • Creatinine
  • Kidney / diagnostic imaging
  • Kidney / physiology
  • Proteinuria / veterinary
  • Renal Insufficiency, Chronic* / veterinary

Substances

  • Biomarkers
  • Contrast Media
  • Creatinine