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Related Experiment Video

Updated: Jul 6, 2026

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Published on: July 3, 2013

Nephrogenic systemic fibrosis--implications for nephrologists.

Georges Saab¹, Ali Abu-Alfa

¹Department of Internal Medicine, Division of Nephrology, University of Missouri, Columbia School of Medicine, MA436 Health Sciences Center, Columbia, MO 65212, USA. saabg@health.missouri.edu

European Journal of Radiology

|March 18, 2008

Summary

Nephrogenic systemic fibrosis (NSF) is a serious condition linked to gadolinium-based contrast agents (Gd-CA) in patients with chronic kidney disease (CKD). This review explores risk factors and the nephrologist's role in preventing NSF.

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Last Updated: Jul 6, 2026

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Published on: July 3, 2013

Area of Science:

Nephrology
Radiology
Toxicology

Background:

Nephrogenic systemic fibrosis (NSF) is a severe fibrotic disease primarily affecting patients with advanced chronic kidney disease (CKD).
A strong association exists between NSF development and exposure to gadolinium-based contrast agents (Gd-CA).
Several co-existing conditions in CKD patients, such as metabolic acidosis and altered mineral metabolism, may influence NSF risk.

Purpose of the Study:

To review the current understanding of NSF pathogenesis in CKD patients.
To analyze potential risk factors contributing to NSF after Gd-CA administration.
To outline the critical role of nephrologists in preventing NSF and managing contrast agent risks.

Main Methods:

Literature review of studies investigating NSF, Gd-CA, and CKD.
Analysis of risk factors associated with NSF development.
Discussion of clinical management strategies from a nephrologist's viewpoint.

Main Results:

Evidence links Gd-CA administration to NSF in CKD patients.
Metabolic acidosis, high-dose erythropoietin, and mineral metabolism disorders are potential contributing factors.
Physicians must balance NSF risks against contrast-induced nephropathy (CIN) risks.

Conclusions:

NSF is a significant concern in CKD patients exposed to Gd-CA.
Careful patient selection and risk factor management are crucial for NSF prevention.
Nephrologists play a vital role in guiding safe contrast agent use in CKD.