Contrast-Agent–Induced Acute Renal Dysfunction — Is Iodixanol the Answer?

In this issue of the Journal, Aspelin et al.1 report findings from a prospective, randomized, double-blind trial that compared iodixanol, a third-generation, iso-osmolar, dimeric, nonionic iodinated contrast agent, with iohexol, a low-osmolar, monomeric, nonionic contrast agent. The use of iodixanol resulted in significantly fewer nephrotoxic effects in high-risk patients undergoing arteriography than iohexol did — findings that are important because a beneficial effect of this iso-osmolar agent on renal function had not previously been conclusively demonstrated in a randomized study.Before the late 1960s, all iodinated contrast agents used for radiologic imaging were ionic monomers with an ionizing carboxyl group . . .