Evaluation of the elimination and safety of gadodiamide injection in patients with hemodialysis

We performed this study to evaluate the safety and elimination of gadodiamide injection in patients with hemodialysis (HD). The subjects were 10 patients on maintenance HD therapy, after receiving gadodiamide injection for magnetic resonance imaging (MRI) examination. The patients' mean age was 59.4 +/- 3.5 years, and their mean hemodialysis period was 70.6 +/- 20.4 months. Diseases for MRI examination were liver tumor (n=2), gallbladder tumor (n=1), renal tumor (n=3), pancreas tumor (n=1), abdominal aortic aneurysm (n=1), and arteriosclerosis obliterans (n=2). HD was performed routinely three times a week for 4 hours. Cellulose triacetate (CTA) membranes were used for 5 patients, polysulphone (PS) for 3 patients and polyester-polymer alloy (PEPA) for 2 patients. Serum levels of gadodiamide were analyzed before and after the first and second HD, and before the third and fourth HD. At the first HD, the concentration of gadodiamide in dialysate was analyzed every hour. Gadodiamide was eventually eliminated over time; 74.1% of the gadodiamide was dialyzed after the first HD and 98.8% after the third HD. There were no significant changes in the removal rate and laboratory parameters between each membrane. The present study suggests that gadodiamide could be removed by HD therapy efficiently thereby indicating that gadodiamide injection is possible in patients with HD.