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An Aptamer-based Sensor for Unchelated Gadolinium(III)
Published on: January 9, 2017
What nephrologists need to know about gadolinium
Jeffrey G Penfield1, Robert F Reilly
1Section of Nephrology at Veterans Affairs North Texas Health Care System and Department of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75216, USA. jeffrey.penfield@va.gov
Nature Clinical Practice. Nephrology
|November 23, 2007
Summary
Gadolinium-based contrast agents pose risks for patients with kidney dysfunction, including nephrogenic systemic fibrosis (NSF) and acute kidney injury. Nephrologists must reassess gadolinium use in patients with declining renal function.
Area of Science:
- Nephrology
- Radiology
- Medical Imaging
Background:
- Gadolinium chelates are widely used MRI contrast agents.
- Historically considered safe, recent evidence highlights potential risks, especially in patients with impaired kidney function.
Purpose of the Study:
- To inform nephrologists about the risks associated with gadolinium chelate administration in patients with renal dysfunction.
- To review the clinical problems, including nephrogenic systemic fibrosis (NSF), acute kidney injury, and laboratory artifacts, linked to gadolinium use.
Main Methods:
- Review of recent studies and clinical observations regarding gadolinium chelate safety.
- Analysis of complications in patients with varying degrees of renal impairment.
Main Results:
- Gadolinium administration in renal dysfunction can lead to nephrogenic systemic fibrosis (NSF), acute kidney injury, and laboratory artifacts like pseudohypocalcemia.
- The risk of these complications increases with declining kidney function.
- Gadodiamide is frequently associated with NSF, but other agents may also pose risks.
Conclusions:
- Nephrologists must carefully weigh the risks and benefits of gadolinium administration in patients with chronic kidney disease (CKD) stage 3 or greater and acute kidney injury.
- Re-evaluation of current guidelines for gadolinium use in vulnerable patient populations is warranted.
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