Safety of gadolinium contrast agent in hemodialysis patients

Okada, Susumu; Katagiri, K.; Kumazaki, Tatsuo; Yokoyama, H.

doi:10.1080/028418501127346756

Cited by 95 publications

(55 citation statements)

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“…After three consecutive hemodialysis sessions over 6 days, 97% of the initial concentration of gadodiamide were eliminated [17]. In another study of 70 patients no side effects were noted [18]. This was also the case in the 6 patients in whom hemodialysis was performed 3 days after the contrast medium injection.…”

Section: Elimination Of Gadolinium-based Contrast Mediamentioning

confidence: 86%

“…The extrarenal elimination of gadolinium is very small and less than 2% of the injected dose is excreted in the feces within 5 days of injection [17]. Good hemodialysability and safety of MRI gadolinium-based contrast agents have been reported [17,18]. After three consecutive hemodialysis sessions over 6 days, 97% of the initial concentration of gadodiamide were eliminated [17].…”

Section: Elimination Of Gadolinium-based Contrast Mediamentioning

confidence: 96%

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Dialysis and contrast media

2002

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Section: Elimination Of Gadolinium-based Contrast Mediamentioning

confidence: 86%

Section: Elimination Of Gadolinium-based Contrast Mediamentioning

confidence: 96%

Dialysis and contrast media

2002

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“…The half-life of gadolinium in patients with normal kidney function is approximately 90 minutes, but in patients with advanced renal impairment, the elimination half-life can be prolonged to more than 30 hours [113]. Although, there is no evidence that hemodialysis immediately after gadolinium exposure lowers the risk or severity of NSF, studies have reported that gadolinium removal was up to 99% after three dialysis sessions [114][115][116]. Restoration of kidney function results in Gd excretion and detection in the urine, even if the contrast agent was administered up to three years prior to transplantation [54,117], suggesting that mobilization from tissue and bone deposits [115,118] can occur after transplantation.…”

Section: Discussionmentioning

confidence: 99%

Renal Transplantation Is Associated with Improved Clinical Outcomes in Nephrogenic Systemic Fibrosis

Yacoub

Kandukurti

Panesar

2013

ISRN Transplantation

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Nephrogenic systemic fibrosis is a debilitating disorder seen in chronic kidney disease patients and is characterized by stiffening of the joints and thickening of the skin. Treatment options are limited, but some patients have had an improvement of their clinical symptoms after renal transplantation and the use of immunosuppression. Although there is a variable response to renal transplantation, it is currently unknown what factors promote a favorable outcome. Our objective was to evaluate if the response to renal transplantation was superior to other treatment modalities and to determine which characteristics allowed for a positive response to occur. We retrieved the data from the literature of 298 reported patients, compared the response to renal transplantation and to other treatments, and analyzed their characteristics. We found that more patients had a higher response to renal transplantation, as determined by softening of the skin and improved joint mobility, and among those that did respond, they had a shorter dialysis vintage. We suggest that if renal transplantation is to be considered as a treatment modality, it should be initiated at the earliest possible in the course of the disease to achieve maximum clinical benefit.

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“…For example, iron oxides are licensed as food coloring agents under the number E172, have been approved by the FDA for use in contact lenses (§ 73.3125), and they form the contrast-generating compound in the MRI contrast agent Lumirem® (ferumoxsil; Guerbet Groupe, France), which is approved for oral and rectal application at concentrations up to 175 mg Fe/l [9,19,20]. Thus, incorporation of iron oxides into the mesh material does not seem to pose any risks of side effects, such as might be present with other MR contrast agents, such as Gd-DTPA from which the toxic element gadolinium could potentially be washed out of the mesh during the long exposure times [21,22,23]. …”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance-Visible Polypropylene Mesh for Pelvic Organ Prolapse Repair

Brocker¹,

Lippus

Alt

et al. 2014

Gynecol Obstet Invest

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Aim: To develop a magnetic resonance (MR)-visible mesh using iron oxides and prove visibility. Methods: In a phantom study, a suitable iron oxide, Fe₃O₄ [iron(II,III) oxide] and FeOOH [iron(III) oxide-hydroxide], concentration was determined using relaxometric MR measurements of the transverse relaxation rates R2 and R2*. Next, a nonabsorbable mesh was designed from the MR-visible threads woven into a polypropylene mesh. The mesh was implanted into a fresh female cadaver via the transobturator route, and MR visibility was assessed with various MR pulse sequences in a clinical 3-tesla system. Results: Optimal contrast was achieved with Fe₃O₄ at 0.2 weight-% in all imaging sequences, and the optimal contrast was achieved in a 3D spoiled gradient-echo (fast low-angle shot) acquisition. In this concentration range the apparent transverse relaxation rate R2* is below 10 ms. The mesh was visible in the cadaver on T1-weighted 3D spoiled gradient-echo images and T1-weighted fast spin-echo images. Conclusion: Mesh materials can be manufactured to be visible on MR with a negative contrast. Fe₃O₄ meshes could simplify follow-up examinations and help diagnose origins of postsurgical lesions after urogynecological procedures with mesh material.

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Safety of gadolinium contrast agent in hemodialysis patients

Cited by 95 publications

References 0 publications

Dialysis and contrast media

Dialysis and contrast media

Renal Transplantation Is Associated with Improved Clinical Outcomes in Nephrogenic Systemic Fibrosis

Magnetic Resonance-Visible Polypropylene Mesh for Pelvic Organ Prolapse Repair

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