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Published on: July 3, 2013
Gadolinium-induced nephrogenic systemic fibrosis.
1Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. rhellman@iupui.edu
Seminars in Nephrology
|July 26, 2011
Summary
Nephrogenic systemic fibrosis (NSF) risk in kidney disease patients has decreased due to restricted gadolinium-based contrast (GBC) use. Current protocols limit GBC in severe renal impairment, reducing NSF incidence.
Area of Science:
- Nephrology
- Radiology
- Toxicology
Background:
- Nephrogenic systemic fibrosis (NSF) is a debilitating condition linked to gadolinium-based contrast (GBC) agents.
- NSF predominantly affects patients with severe renal impairment (MDRD creatinine clearance <30 mL/min/1.73 m(2)).
Purpose of the Study:
- To review the current use of gadolinium-based contrast agents in patients with kidney disease.
- To assess the impact of recent changes in GBC administration protocols on NSF incidence.
Main Methods:
- Review of literature and clinical data on NSF incidence and GBC administration.
- Analysis of changes in GBC protocols for patients with renal impairment since 2006.
Main Results:
- A significant decrease in NSF incidence has been observed since 2006.
- This reduction is attributed to stricter protocols limiting GBC in patients with creatinine clearance <30 mL/min/1.73 m(2).
- Use of less toxic GBC agents and lower doses has also contributed.
Conclusions:
- Current protocols effectively mitigate NSF risk in patients with severe kidney disease.
- Careful consideration of GBC use in renal impairment remains crucial for patient safety.
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