The use of ionic and nonionic contrast agents and the effects of hydration in the post cardiac transplant patient with moderate renal insufficiency.

To determine the effects of ionic (diatrizoate) and nonionic (iopamidol) contrast and of hydration, 90 asymptomatic cyclosporine-treated cardiac transplant patients with moderate renal insufficiency (serum creatinine greater than or equal to 1.5 mg/dL) undergoing cardiac catheterization were evaluated. All patients were hydrated with intravenous fluid (5% dextrose and 0.5 normal saline) over a twelve-hour period prior to catheterization and with oral fluids thereafter. Thirty patients received iopamidol (Group I) and 60 were given diatrizoate (Group II). Renal function was determined the day before and after catheterization in all patients of Group I and in 30 patients of Group II (Group IIa). In the remaining 30 patients of Group II renal function was also determined before contrast administration (Group IIb). The dose of dye was similar in all groups (I: 139 +/- 55 mL, IIa: 140 +/- 58 mL, IIb: 128 +/- 38 mL). There was a significant decrease in BUN (I: 41 +/- 10 to 33 +/- 8 mg/dL [p less than 0.005], IIa: 42 +/- 9 to 33 +/- 8 mg/dL mg/dL [p less than 0.001], IIb: (44 +/- 12 to 34 +/- 10 mg/dL [p less than 0.005]) and a small decrease in serum cratinine after catheterization (I: 2.0 +/- 0.3 to 1.9 +/- 0.3 mg/dL, IId: 2.0 +/- 0.3 to 1.9 +/- 0.3 mg/dL, IIb: 2.1 +/- 0.4 to 1.8 +/- 0.4 mg/dL [p less than 0.005].(ABSTRACT TRUNCATED AT 250 WORDS)