Biochemical Changes Associated with Intravenous Use of Contrast Media

Abstract

Introduction: The general indication for the use of iodinated contrast media (CM) is to create an X-ray attenuation differential in tissues in order to increase the visualization of the disease process. The use of CM can be associated with clinical and biochemical effects some of which may be harmful e.g. contrast induced nephropathy, haemodynamic alterations and idiosyncratic reactions amongst others. This hospital- based prospective analytical study investigated biochemical derangements associated with the use of contrast media.

Methods: One hundred and eighty consenting adult patients who received intravenous contrast media during radiological investigations at the University of Benin Teaching Hospital, Edo State, Nigeria were recruited over a 6-month period. Data on their socio- demographic characteristics and health status were collated. Venous blood was collected pre- and up to 72 hour- post contrast studies to measure for serum electrolytes, urea, creatinine and albumin. Urine was similarly collected and examined using dipsticks for abnormalities.

Results: The mean serum sodium and potassium decreased significantly from baseline values after 24hours, while the mean serum urea, creatinine and urine pH increased. These changes returned to normal by 72hrs post contrast exposure, except for one patient who required haemodialysis. Fifty-one (51) out of 142 patients developed CIN defined as elevation of serum creatinine by > 25%, 24-72hrs after exposure to contrast.

Conclusion: Intravenous use of contrast media is associated with significant but mostly transient biochemical derangements. A longer follow-up is however required to possibly exclude future deleterious outcome.