Related Experiment Video

Updated: Aug 31, 2025

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
08:50

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

23.8K

Nephrogenic Systemic Fibrosis in Patients with Chronic Kidney Disease after the Use of Gadolinium-Based Contrast

Sebastian Gallo-Bernal1,2, Nasly Patino-Jaramillo3, Camilo A Calixto2,4

  • 1Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA.

Diagnostics (Basel, Switzerland)
|August 26, 2022
PubMed

Insights

Gadolinium contrast agents are vital for cardiac MRI but carry a risk of nephrogenic systemic fibrosis (NSF) in kidney disease patients. Newer agents are safer, yet awareness of NSF risks and prevention remains crucial.

Area of Science:

  • Cardiology
  • Radiology
  • Nephrology

Background:

  • Gadolinium-enhanced cardiac MRI is essential for cardiovascular disease diagnosis and management.
  • Nephrogenic systemic fibrosis (NSF) is a serious concern in patients with renal dysfunction exposed to gadolinium contrast agents.
  • While newer macrocyclic agents show improved safety profiles in chronic kidney disease, vigilance is necessary.

Purpose of the Study:

  • To review the current evidence on the pathophysiology, clinical presentation, diagnosis, and prevention of NSF.
  • To highlight the importance of understanding NSF risk factors and maintaining clinical suspicion.
  • To provide guidance on the safe use of gadolinium-based contrast agents in at-risk populations.

Main Methods:

  • Comprehensive literature review of studies on gadolinium-based contrast agents and NSF.
  • Analysis of existing data on NSF physiopathology, clinical manifestations, and diagnostic criteria.
  • Evaluation of prevention strategies and risk mitigation for NSF.

Main Results:

  • Gadolinium exposure, particularly with older linear agents, is linked to NSF in patients with impaired renal function.
  • Macrocyclic gadolinium agents demonstrate a significantly lower risk of NSF compared to linear agents.
  • Early recognition and prevention strategies are key to managing NSF risk.

Conclusions:

  • Despite advancements in gadolinium-based contrast agents, a thorough understanding of NSF is critical for safe clinical practice.
  • Clinicians must remain vigilant for NSF in patients with cardiovascular conditions and renal impairment.
  • Risk stratification and appropriate agent selection are paramount to minimize NSF incidence.

Keywords:
cardiac magnetic resonancechronic kidney diseasegadolinium-based contrast agentsnephrogenic systemic fibrosis

More Related Videos

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis10:26

A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis

Published on: June 2, 2015

17.4K
Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

12.1K

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
55
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
74
Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
21
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
70
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
73
Nephrons01:10

Nephrons

The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
3.3K