High-dose administration of nonionic contrast media: a retrospective review

Radiology. 1996 Jul;200(1):119-22. doi: 10.1148/radiology.200.1.8657898.


Purpose: To assess the safety of high-dose nonionic contrast media (CM) during a single radiologic procedure.

Materials and methods: From November 1991 to August 1995, 255 high-dose angiographic procedures were performed in 228 patients with normal serum creatinine (SCr) levels (< or = 1.6 mg/dL [141 mumol/L]). All patients received 250-800 mL low-osmolarity CM (300 mg iodine per milliliter). Pre- and postprocedure SCr levels were assessed. Urine output was measured daily in the 75 patients who received more than 400 mL CM. With linear regression analysis, a dose-related elevation in SCr levels was calculated.

Results: No patient developed abnormal SCr levels (> 1.6 mg/dL [141 mumol/L]) as a result of the CM. Among the patients who received more than 400 mL, none developed oliguria over the first 36 hours. With follow-up up to 3 years, no patient experienced delayed clinical renal failure. In 11 (4.3%) patients, the SCr levels increased more than 25%, but all increases were within expected limits (chi 2 analysis). Linear regression analysis revealed a 0.015 mg/dL (1 mumol/L) increase in SCr levels per 100 mL CM.

Conclusion: Intravenous administration of high-dose low-osmolarity iodinated CM appears safe in patients without renal dysfunction or other underlying risk factors, in doses as large as 800 mL (300 mg iodine per milliliter).

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography*
  • Contrast Media / administration & dosage*
  • Contrast Media / adverse effects
  • Creatinine / blood
  • Female
  • Humans
  • Iopamidol / administration & dosage*
  • Iopamidol / adverse effects
  • Kidney / drug effects
  • Kidney Diseases / chemically induced
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors


  • Contrast Media
  • Creatinine
  • Iopamidol