Intravascular use approved iodinated contrast agents should be used unless the patient has a known severe contrast allergy or still retains compromised renal function. An allergy to shellfish does not indicate a risk for an allergic reaction to IV dye and premedication is not necessary. Modern intravenous contrast agents are typically based on iodine. The more iodine, the denser the radiographic image where contrast is present and the contrast is more viscous. For use in dialysis interventions, an iodine concentration around 300 mg/mL is sufficient. There are a variety of manufacturers that supply this product in varying forms and concentrations. In reality, for applications mentioned within this publication, there is little difference. Intravenous contrast may be bound either in an organic nonionic (low osmolarity) compound or an ionic compound (high osmolarity). Although the cost is lower for ionic agents, one should endeavor to use nonionic opposed to ionic contrast when possible. It is associated with a lower incidence of heat sensation, pain, produces fewer cardiovascular changes, allergic reactions, and nephrotoxicity but has not shown a reduction in neurotoxicity or definite life-threatening reactions. The risk of severe life-threatening contrast reaction is lower than 1:10,000 with direct related mortality 10 times lower than this (1:100,000).
KeywordsShellfish Carbon dioxide Gadolinium Nephrogenic systemic fibrosis Nephrotoxicity Viscosity Contrast induced nephropathy