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Oloko A, Talreja H, Davis A, McCormick B, Clark E, Akbari A, Kong J, Hiremath S: Does Iodinated Contrast Affect Residual Renal Function in Dialysis Patients? A Systematic Review and Meta-Analysis. Nephron DOI 10.1159/000505576
The adverse effects of iodinated contrast media (CM) on kidney function continues to be very controversial. It is likely that the effects of CM have been overstated in the past. Most of the studies of this issue have involved patients with normal or moderately reduced renal function and relatively few have addressed the effects of CM on residual kidney function (RKF) in patients with ESRD treated by dialysis.
Oloko and colleagues have remedied this knowledge gap (in part) by focusing on the adverse effects of CM on RKF by conducting a systematic review and meta-analysis of published studies. A total of 7 studies (3 observational and 4 controlled) including 282 patients receiving hemo- or peritoneal dialysis were examined. The weighted mean difference for RKF after CM was only –0.6 mL/min (not significant), but there was significant heterogeneity among the included studies and the 95% confidence intervals were quite wide (–0.66 to +0.34 mL/min). Insufficient data were available to categorize clinical outcomes.
While the accumulated data do not support an adverse effect of CM on RKF, they do not exclude such an effect with high confidence. However, these data do not suggest that post-CM exposure dialysis of such patients is likely to have a beneficial effect. Further studies are required to be able to draw definite conclusions concerning the risks of administration of CM to dialysis patients.
