Dialysis is not indicated immediately after administration of nonionic contrast agents in patients with end-stage renal disease treated by maintenance dialysis

This study was undertaken to determine the necessity of immediate dialysis after intravascular injection of contrast material in patients with end-stage renal disease who are being maintained on hemodialysis. Although many physicians support this practice, we could find no reports of studies to confirm or refute its necessity. We studied 10 patients being treated with hemodialysis who were undergoing 11 diagnostic procedures that required intravascular contrast material. The patients received 40-225 ml of nonionic contrast material and were followed up with clinical examination and laboratory analysis to determine any adverse effects from contrast administration or the need for dialysis or both. No significant changes in blood pressure, ECG, total serum protein level of osmolality, extracellular fluid volume, or body weight occurred after injection of contrast material. None of the patients had clinical features that necessitated emergent dialysis. We conclude that nonionic contrast material can be given safely to patients with end-stage renal disease who are being maintained on hemodialysis. Immediate postprocedural dialysis is unwarranted as a routine practice.