Systemic hypocalcemia after clinical injections of radiographic contrast media: amelioration by omission of calcium chelating agents

Radiology
L E Mallette, L S Gomez

Abstract

Intravascular injection of some radiographic contrast media causes a fall in the concentration of unbound serum calcium (Ca++) and an increase in serum immunoreactive parathyroid hormone (iPTH). The decrease in Ca++ levels was attributed to the presence in the contrast media of calcium chelating agents (disodium edetate and sodium citrate) and to the effects of high ionic strength and hemodilution on calcium ion activity. In the present study, we have tested whether omission of the calcium chelating agents from solutions of diatrizoate will lessen the alterations in systemic calcium metabolism. We compared Renografin-76 (RG-76) (diatrizoate meglumine and diatrizoate sodium), which contains disodium edetate and sodium citrate, with Hypaque-76 (H-76) (diatrizoate meglumine, diatrizoate sodium), which contains no calcium chelating activity. A bolus injection of a mean dose of 62 ml of either contrast medium decreased levels of Ca++ significantly (P less than 0.01) at five minutes. The decrease was significantly greater (P less than 0.025) with RG-76 (0.096 +/- 0.018 mM, mean +/- SE) than it was with H-76 (0.049 +/- 0.018 mM, mean +/- SE). The level of iPTH increased (P less than 0.01) by 68 +/- 13 nanoliter equivalents (nleq) per ...Continue Reading

Citations

Feb 1, 1986·Annals of Neurology·P Van den BerghT L Munsat
Oct 1, 1987·The New England Journal of Medicine·M A Bettmann
Oct 1, 1991·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·J H Ladenson
Jun 1, 1994·The Journal of Urology·J J Keizur, S Das
Nov 4, 2017·Contrast Media & Molecular Imaging·Sigrid OtnesHenrik S Thomsen

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