Risk of Nephrogenic Systemic Fibrosis: Evaluation of Gadolinium Chelate Contrast Agents at Four American Universities

Wertman, Rebecca; Altun, Ersan; Martín, Diego R.; Mitchell, Donald G.; Leyendecker, John R.; O’Malley, Ryan B.; Parsons, Daniel J.; Fuller, Edwin R.; Semelka, Richard C.

doi:10.1148/radiol.2483072093

Cited by 173 publications

(117 citation statements)

References 26 publications

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…In vivo major differences between the different GBCAs with regard to short-and long-term Gd skin concentrations and in the propensity to induce skin lesions have been described. Interestingly, also in clinical studies similar differences between the GBCAs and the risk to induce NSF were reported (52,53).…”

Section: Discussionsupporting

confidence: 52%

Gadolinium‐based contrast agents and NSF: Evidence from animal experience

Sieber

Steger‐Hartmann

Lengsfeld

et al. 2009

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Nephrogenic systemic fibrosis (NSF) is a potentially severe systemic disease typically characterized by fibrosis of the skin and connective tissues. The etiology of NSF is still unknown but is likely to be multifactorial. Specific triggers under scientific evaluation have included surgery and/or the occurrence of thrombosis or other vascular injury, proinflammatory state, the administration of high doses of erythropoietin, and more recently the use of gadolinium-based contrast agents (GBCAs). The aim of this review is to summarize knowledge regarding the pathogenesis of NSF and the potential role of GBCAs in its pathology, with a focus on animal experiments. The potential role of complex stability of GCBAs will be highlighted by results from several in vitro and in vivo experiments in rodent models of NSF.

show abstract

Section: Discussionsupporting

confidence: 52%

Gadolinium‐based contrast agents and NSF: Evidence from animal experience

Sieber

Steger‐Hartmann

Lengsfeld

et al. 2009

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…El deterioro de la función renal, tanto agudo como crónico, es considerado el mayor factor de riesgo para generar FSN [18][19][20] . No existe predilección por etiología o duración de la falla renal 21,22 .…”

Section: Función Renalunclassified

“…Se estima que pacientes con ERC en etapa 5 (filtración glomerular < 15 ml/min/1,73 m 2 ) y etapa 4 (filtración glomerular entre 15 a 29 ml/min/1,73 m 2 ) tienen entre 1% y 7% de probabilidad de desarrollar FSN posterior a una o más exposiciones a algunos MC-Gd 8,9,16,18,19,22,23 . Sólo se ha publicado un reporte de caso en el cual el paciente desarrolló FSN con valores de filtración glomerular sobre 30 ml/min/1,73 m 2 24 .…”

Section: Función Renalunclassified

Fibrosis sistémica nefrogénica: la pandemia que no fue

U¹,

Prieto-Rayo²

2014

Rev. méd. Chile

View full text Add to dashboard Cite

Causal relationship between the use of gadolinium based contrast media and nephrogenic systemic fibrosis L a fibrosis sistémica nefrogénica (FSN) es una grave enfermedad iatrogénica que alarmó a la comunidad médica a partir de la descripción de la relación causal del uso de medios de contraste basados en gadolinio (MC-Gd) para resonancia magnética (RM), en pacientes con enfermedad renal avanzada, el año 2006 1 . Dado el uso masivo y universal de estos fármacos, hasta ese momento con un perfil de seguridad impecable, esta patología se perfilaba como una verdadera pandemia. Ocho años después y como un hecho casi inédito en la historia de la medicina, podemos afirmar que ha sido controlada con simples medidas de prevención 2 .Se trata de una enfermedad poco frecuente, que hasta la fecha se ha desarrollado únicamente en pacientes con disminución severa de la función renal, ya sea aguda o crónica 3 . Clínicamente simula un esclero mixedema que se desarrolla en días o semanas 4,5 . Este artículo tiene como objetivo realizar una revisión actualizada de la FSN, revalorando su relevancia como complicación iatrogénica en pacientes con disfunción renal, con especial énfasis en los factores de riesgo y su prevención y por último conocer su realidad en Chile. Historia de la FSNEsta entidad clínica fue reconocida por primera vez en el año 1997 y descrita en el año 2000 por Cowper y cols. como una enfermedad cutánea escleromixedematosa-símil en pacientes con enfermedad renal crónica (ERC) en diálisis 6 . Inicialmente se pensaba que la enfermedad afectaba sólo la piel de los pacientes, por lo que se le llamó dermatopatía fibrosante nefrogénica. Posteriormente se comprobó la afección de múltiples órganos y sistemas por lo que en el año 2005 se propuso cambiar su nombre a FSN 7 .En el año 2006, múltiples autores notaron una fuerte asociación entre la administración de MC-

show abstract

“…Despite the limitations of the MDRD equation, it should be noted that the risk assessment for NSF in the literature has been largely based on eGFR assessment by the MDRD equation, with the great majority of cases occurring in patients with an eGFR <30 mL/ min/1.73 m 2 (32,33). It is of great importance to stress that the MDRD formula, which assumes a stable serum creatinine level, is not reliable in patients with acute renal failure, which is an independent risk factor for NSF (34,35).…”

Section: Mdrd Equationmentioning

confidence: 99%

Estimation of renal function in patients with chronic kidney disease

Kooman

2009

Magnetic Resonance Imaging

View full text Add to dashboard Cite

The risk of nephrogenic systemic fibrosis after gadolinium exposure is inversely related to renal function. Various methods are available to assess the glomerular filtration rate (GFR). Prediction formulas based on serum creatinine, such as the abbreviated Modification of Diet in Renal Disease (MDRD) formula, are most commonly used and appear acceptable for clinical purposes in the majority of patients with chronic renal failure. However, especially in patients at the extremes of body composition, the results from creatinine‐based equations should be interpreted with caution. In those patients, additional methods, such as timed urine collections, predictions based on cystatin, single‐shot radiotracer methods, or, optimally, inulin clearance could be considered. In this review, the strengths and limitations of different methods to assess GFR are discussed. Apart from inulin clearance, no method can be considered the gold standard in the assessment of GFR. In cases of doubt, the decision to use gadolinium‐enhanced magnetic resonance imaging should always be based on clinical risk–benefit judgment. J. Magn. Reson. Imaging 2009;30:1341–1346. © 2009 Wiley‐Liss, Inc.

show abstract

Risk of Nephrogenic Systemic Fibrosis: Evaluation of Gadolinium Chelate Contrast Agents at Four American Universities

Abstract: The benchmark incidence of NSF was much greater at the two centers where gadodiamide was used than at the two centers where gadopentetate dimeglumine was used.

Cited by 173 publications

References 26 publications

Gadolinium‐based contrast agents and NSF: Evidence from animal experience

Gadolinium‐based contrast agents and NSF: Evidence from animal experience

Fibrosis sistémica nefrogénica: la pandemia que no fue

Estimation of renal function in patients with chronic kidney disease

Contact Info

Product

Resources

About