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Refined Murine Model of Idiopathic Pulmonary Fibrosis
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Gadolinium-Induced Fibrosis.

Derrick J Todd1,2, Jonathan Kay3

  • 1Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115.

Annual Review of Medicine
|January 16, 2016
PubMed
Summary
This summary is machine-generated.

Gadolinium-based contrast agents (GBCAs) are linked to nephrogenic systemic fibrosis (NSF) in patients with kidney disease. Avoiding high-risk GBCAs has nearly eliminated new NSF cases, a condition now proposed to be renamed gadolinium-induced fibrosis (GIF).

Keywords:
Gdchronic kidney diseasefibrosing disordersgadolinium-based contrast agentsmagnetic resonance imagingnephrogenic systemic fibrosis

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Area of Science:

  • Nephrology
  • Radiology
  • Toxicology

Background:

  • Gadolinium-based contrast agents (GBCAs) were initially considered safe for patients with renal disease.
  • However, a strong association emerged between GBCA use and nephrogenic systemic fibrosis (NSF), a severe fibrosing disorder.
  • NSF predominantly affects individuals with advanced renal dysfunction.

Purpose of the Study:

  • To provide a historical overview of nephrogenic systemic fibrosis (NSF).
  • To examine the association between GBCA exposure and NSF.
  • To propose renaming NSF to gadolinium-induced fibrosis (GIF) to better reflect the causative agent.

Main Methods:

  • Historical review of clinical data and scientific literature.
  • Analysis of the temporal relationship between GBCA introduction/restriction and NSF incidence.
  • Evaluation of evidence supporting a causal link between GBCAs and NSF.

Main Results:

  • NSF emerged following the introduction of certain GBCAs and declined sharply after their restriction in patients with renal disease.
  • Strong evidence supports a causative relationship between specific GBCA exposure and NSF.
  • The proposed name, gadolinium-induced fibrosis (GIF), accurately reflects the disease etiology.

Conclusions:

  • Use of high-risk GBCAs, like gadodiamide, should be avoided in patients with renal disease.
  • Restriction of GBCA use in this population has led to the near elimination of new NSF cases.
  • Emerging antifibrotic therapies may offer future treatment options for patients with GIF.