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Gadolinium-enhanced MR imaging and nephrogenic systemic fibrosis: retrospective study of a renal replacement therapy

Tara Anne Collidge1, Peter Campbell Thomson, Patrick Barry Mark

  • 1Renal Unit and Radiology Department, Glasgow Royal Infirmary, Castle Street, 3rd Floor Walton Bldg, Glasgow G4 0SF, Scotland.

Radiology
|August 21, 2007
PubMed

Insights

Gadolinium-based contrast agents are associated with nephrogenic systemic fibrosis in dialysis patients. Higher cumulative doses and more frequent administration increased the risk of developing this condition.

Area of Science:

  • Nephrology
  • Radiology
  • Toxicology

Background:

  • Nephrogenic systemic fibrosis (NSF) is a debilitating condition linked to gadolinium-based contrast agents (GBCAs).
  • Dialysis-dependent patients with established renal failure are particularly vulnerable to NSF.
  • Understanding the relationship between GBCA exposure and NSF is crucial for patient safety.

Purpose of the Study:

  • To compare GBCA administration frequency and cumulative dose in dialysis patients who developed NSF versus those who did not.
  • To investigate the association between GBCA exposure parameters and NSF development.

Main Methods:

  • Retrospective analysis of adult dialysis patients in West Scotland (2000-2006).
  • Recorded diagnoses of NSF, GBCA-enhanced MRI episodes, and cumulative GBCA doses.
  • Analyzed outcomes using parametric and nonparametric statistical tests.

Main Results:

  • 14 out of 1826 patients developed NSF.
  • Patients with NSF were significantly more likely to have undergone GBCA-enhanced MRI (93% vs 22.5%, P<.001).
  • NSF patients received higher median cumulative doses of gadodiamide (0.39 vs 0.23 mmol/kg, P=.008) and more GBCA-enhanced MR imaging sessions.

Conclusions:

  • GBCA administration is positively associated with NSF development in patients with renal failure.
  • Higher cumulative doses of gadodiamide and increased dosing events correlate with increased NSF risk.
Abstract

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