Gadolinium-Containing Magnetic Resonance Imaging Contrast and Nephrogenic Systemic Fibrosis: A Case-Control Study

Kallen, Alexander J.; Jhung, Michael A.; Cheng, Steven; Hess, Theresa; Turabelidze, George; Abramova, Liana; Arduino, Matthew J.; Guarner, Jeannette; Pollack, Brian P.; Saab, Georges; Patel, Priti R.

doi:10.1053/j.ajkd.2007.12.036

Cited by 86 publications

(65 citation statements)

References 24 publications

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“…A concern for GFR measurement, particularly in patients with CKD, is the potential adverse effects of gadoliniumbased MR contrast agents like nephrogenic systemic fibrosis (14), which is linked to a high cumulative dose of gadolinium (15). Notably, although clinical protocols utilize 5-20 mM of gadolinium-based contrast agents, GFR measurements with a dose as low as 1.4-2.8 mM are feasible (16), yet a dose of gadolinium that is completely safe to use in patients with severely impaired renal function has not been identified.…”

Section: Gfrmentioning

confidence: 99%

Renal Relevant Radiology

Ebrahimi

Textor

Lerman

2014

Clinical Journal of the American Society of Nephrology

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SummaryBecause of its noninvasive nature and provision of quantitative measures of a wide variety of physiologic parameters, functional magnetic resonance imaging (MRI) shows great potential for research and clinical applications. Over the past decade, application of functional MRI extended beyond detection of cerebral activity, and techniques for abdominal functional MRI evolved. Assessment of renal perfusion, glomerular filtration, interstitial diffusion, and parenchymal oxygenation turned this modality into an essential research and potentially diagnostic tool. Variations in many renal physiologic markers can be detected using functional MRI before morphologic changes become evident in anatomic magnetic resonance images. Moreover, the framework of functional MRI opened a window of opportunity to develop novel pathophysiologic markers. This article reviews applications of some well validated functional MRI techniques, including perfusion, diffusion-weighted imaging, and blood oxygen level-dependent MRI, as well as some emerging new techniques such as magnetic resonance elastography, which might evolve into clinically useful tools.

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Section: Gfrmentioning

confidence: 99%

Renal Relevant Radiology

Ebrahimi

Textor

Lerman

2014

Clinical Journal of the American Society of Nephrology

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“…This is particularly the case for gadodiamide, since almost all NSF cases are associated with this agent. We have noted (15) [32][33][34]. Chemical analysis would suggest that, once deposited, gadolinium may collect and be retained indefinitely within the tissues, including skin and bone (35).…”

Section: Nephrogenic Systemic Fibrosis (Nsf)mentioning

confidence: 92%

Nephrogenic systemic fibrosis versus contrast‐induced nephropathy: Risks and benefits of contrast‐enhanced MR and CT in renally impaired patients

Martín

Semelka

Chapman

et al. 2009

Magnetic Resonance Imaging

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Magnetic resonance imaging (MRI) and computed tomography (CT) have become essential to diagnostic evaluation of many, or most, important medically and surgically treated diseases. It is important to consider comprehensively the implications in making decisions when choosing one or the other cross-sectional imaging modality. Factors to consider include the relative risks of the contrast agent. Other factors include the relative procedural risks, including radiation risks and the relative expected diagnostic yield of the examination technique (1,2). In this review we describe both nephrogenic systemic fibrosis and contrast-induced nephropathy to compare the implications with regard to relative risks and benefits of contrast-enhanced MRI or CT in patients with impaired renal function.

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“…Data on the type and dose of Gd used is not available in all studies. For those studies that do report dose-effect, an increased NSF risk with either increasing cumulative Gd dose over multiple examinations or with a high single dose during a single examination is recorded [30,33,36,[42][43][44]. One observational study reports an average 2.4 % risk of developing NSF for each radiological study using Gd in at-risk patients [32].…”

Section: Evidence For a Link With Gadolinium-based Contrast Agentsmentioning

confidence: 99%

Gadolinium and nephrogenic systemic fibrosis: an update

2013

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Nephrogenic systemic fibrosis (NSF) is a multisystem disease seen exclusively in patients with renal impairment. It can be severely debilitating and sometimes fatal. There is a strong association with gadolinium-based contrast agents used in magnetic resonance imaging (MRI). Risk factors include renal impairment and proinflammatory conditions, e.g. major surgery and vascular events. Although there is no single effective treatment for NSF, the most successful outcomes are seen following restoration of renal function, either following recovery from acute kidney injury or following renal transplantation. There have been ten biopsy-proved pediatric cases of NSF, with no convincing evidence that children have a significantly altered risk compared with the adult population. After implementation of guidelines restricting the use of gadolinium-based contrast agents in at-risk patients, there has been a sharp reduction in new cases and no new reports in children. Continued vigilance is recommended: screening for renal impairment, use of more stable gadolinium chelates, consideration of non-contrast-enhanced MRI or alternative imaging modalities where appropriate.

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Gadolinium-Containing Magnetic Resonance Imaging Contrast and Nephrogenic Systemic Fibrosis: A Case-Control Study

Cited by 86 publications

References 24 publications

Renal Relevant Radiology

Renal Relevant Radiology

Nephrogenic systemic fibrosis versus contrast‐induced nephropathy: Risks and benefits of contrast‐enhanced MR and CT in renally impaired patients

Gadolinium and nephrogenic systemic fibrosis: an update

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