Nephrogenic systemic fibrosis: a concise review for cardiologists

Tex Heart Inst J. 2010;37(5):508-15.

Abstract

Nephrogenic systemic fibrosis is a recently recognized disease entity that is potentially debilitating. The exact pathogenesis of nephrogenic systemic fibrosis is unclear, but the disease has been linked with the use of gadolinium-based contrast agents, predominantly in patients with acute renal failure or end-stage renal disease. Consequent to increased physician awareness of this link, the incidence of nephrogenic systemic fibrosis has begun to decrease. The aims of this review are to provide a concise summary of the approved gadolinium-based contrast agents available in the United States, to discuss the postulated pathogenesis of nephrogenic systemic fibrosis, to describe the clinical features of the disease, and to provide broad recommendations for gadolinium-based contrast agent use.

Keywords: Chelating agents/adverse effects; gadolinium/diagnostic use/toxicity; magnetic resonance imaging/methods; nephrogenic fibrosing dermopathy/chemically induced; nephrogenic systemic fibrosis.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / complications
  • Cardiovascular Diseases / diagnosis*
  • Contrast Media / adverse effects*
  • Gadolinium / adverse effects*
  • Humans
  • Kidney Failure, Chronic / complications
  • Magnetic Resonance Imaging / adverse effects*
  • Nephrogenic Fibrosing Dermopathy / diagnosis
  • Nephrogenic Fibrosing Dermopathy / etiology*
  • Nephrogenic Fibrosing Dermopathy / therapy
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors

Substances

  • Contrast Media
  • Gadolinium