TY - JOUR
T1 - Gadolinium and Nephrogenic Systemic Fibrosis
T2 - Have We Overreacted?
AU - Penfield, Jeffrey G.
AU - Reilly, Robert F.
N1 - Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2011/9
Y1 - 2011/9
N2 - Imaging is an increasingly important part of clinical medicine and contrast enhancement adds valuable diagnostic information. Prior to 2006 gadolinium based contrast agents (GBCA) were used in patients with kidney disease in an attempt to avoid the adverse consequences of iodinated contrast agents. The amount administered often exceeded the United States Food and Drug Administration (FDA)-recommended dosing. After the association between GBCA and nephrogenic systemic fibrosis (NSF) was reported, usage of GBCA was markedly reduced in patients with kidney disease. As a result, iodinated contrast was often used in place of GBCA. Recently, several studies showed that the risk of NSF using GBCA with increased thermodynamic and kinetic stability or increased relaxivity along with a restricted use policy has dramatically reduced NSF risk in patients with chronic kidney disease (CKD). We discuss the risks of GBCA and iodinated contrast use in different stages of CKD and suggest that in some situations GBCA use may pose less overall risk to the patient with advanced kidney disease.
AB - Imaging is an increasingly important part of clinical medicine and contrast enhancement adds valuable diagnostic information. Prior to 2006 gadolinium based contrast agents (GBCA) were used in patients with kidney disease in an attempt to avoid the adverse consequences of iodinated contrast agents. The amount administered often exceeded the United States Food and Drug Administration (FDA)-recommended dosing. After the association between GBCA and nephrogenic systemic fibrosis (NSF) was reported, usage of GBCA was markedly reduced in patients with kidney disease. As a result, iodinated contrast was often used in place of GBCA. Recently, several studies showed that the risk of NSF using GBCA with increased thermodynamic and kinetic stability or increased relaxivity along with a restricted use policy has dramatically reduced NSF risk in patients with chronic kidney disease (CKD). We discuss the risks of GBCA and iodinated contrast use in different stages of CKD and suggest that in some situations GBCA use may pose less overall risk to the patient with advanced kidney disease.
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U2 - 10.1111/j.1525-139X.2011.00945.x
DO - 10.1111/j.1525-139X.2011.00945.x
M3 - Editorial
C2 - 21913988
AN - SCOPUS:80054678346
SN - 0894-0959
VL - 24
SP - 480
EP - 486
JO - Seminars in Dialysis
JF - Seminars in Dialysis
IS - 5
ER -