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See Latest ArticlesGadolinium-Associated Nephrogenic Systemic Fibrosis
American Family Physician, 10/01/09
Schlaudecker JD et al. – Nephrogenic systemic fibrosis is a progressive, potentially fatal multiorgan system fibrosing disease related to exposure of patients with renal failure to the gadolinium–based contrast agents used in magnetic resonance imaging. Because of this relationship between nephrogenic systemic fibrosis and gadolinium–based contrast agents, the U.S. Food and Drug Administration currently warns against using gadolinium–based contrast agents in patients with a glomerular filtration rate less than 30 mL per minute per 1.73 m2, or any acute renal insufficiency related to the hepatorenal syndrome or perioperative liver transplantation. There have been reports of nephrogenic systemic fibrosis developing in patients not exposed to gadolinium–based contrast agents, but most patients have the triad of gadolinium exposure through contrast–enhanced magnetic resonance imaging, renal failure, and a proinflammatory state, such as recent surgery, endovascular injury, or sepsis.
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