Nephrogenic systemic fibrosis versus contrast‐induced nephropathy: Risks and benefits of contrast‐enhanced MR and CT in renally impaired patients

Magnetic resonance imaging (MRI) and computed tomography (CT) have become essential to diagnostic evaluation of many, or most, important medically and surgically treated diseases. It is important to consider comprehensively the implications in making decisions when choosing one or the other cross‐sectional imaging modality. Factors to consider include the relative risks of the contrast agent. Other factors include the relative procedural risks, including radiation risks and the relative expected diagnostic yield of the examination technique ( 1 , 2 ). In this review we describe both nephrogenic systemic fibrosis and contrast‐induced nephropathy to compare the implications with regard to relative risks and benefits of contrast‐enhanced MRI or CT in patients with impaired renal function. J. Magn. Reson. Imaging 2009;30:1350–1356. © 2009 Wiley‐Liss, Inc.

[1]  Hanns-Joachim Weinmann,et al.  Gadolinium‐based contrast agents and their potential role in the pathogenesis of nephrogenic systemic fibrosis: The role of excess ligand , 2008, Journal of magnetic resonance imaging : JMRI.

[2]  Shao-Pow Lin,et al.  MR contrast agents: Physical and pharmacologic basics , 2007, Journal of magnetic resonance imaging : JMRI.

[3]  S. Cowper Nephrogenic systemic fibrosis: a review and exploration of the role of gadolinium. , 2007, Advances in dermatology.

[4]  Martin R Prince,et al.  3D contrast‐enhanced MR angiography , 2007, Journal of magnetic resonance imaging : JMRI.

[5]  G. Dangas,et al.  The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. , 2000, Journal of the American College of Cardiology.

[6]  J. Zic,et al.  Gadolinium deposition in nephrogenic fibrosing dermopathy. , 2007, Journal of the American Academy of Dermatology.

[7]  J. Sandstede,et al.  Evaluation of the nephrotoxicity of iodixanol in patients with predisposing factors to contrast medium induced nephropathy referred for contrast enhanced computed tomography. , 2007, European journal of radiology.

[8]  Lone Skov,et al.  Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging. , 2006, Journal of the American Society of Nephrology : JASN.

[9]  J. Topf,et al.  Nephrogenic Fibrosing Dermopathy , 2008, TheScientificWorldJournal.

[10]  Kirk N. Garratt,et al.  Incidence and Prognostic Importance of Acute Renal Failure After Percutaneous Coronary Intervention , 2002, Circulation.

[11]  K. Farrington,et al.  Reviews: Residual Renal Function: Considerations on Its Importance and Preservation in Dialysis Patients , 2004, Seminars in dialysis.

[12]  S. Cowper,et al.  Nephrogenic systemic fibrosis: An update , 2006, Current rheumatology reports.

[13]  H. Thomsen,et al.  The ACTIVE Trial: Comparison of the Effects on Renal Function of Iomeprol-400 and Iodixanol-320 in Patients With Chronic Kidney Disease Undergoing Abdominal Computed Tomography , 2008, Investigative radiology.

[14]  H. Thomsen,et al.  Nephrogenic systemic fibrosis and nonionic linear chelates. , 2007, AJR. American journal of roentgenology.

[15]  V. Runge Gadolinium and nephrogenic systemic fibrosis. , 2009, AJR. American journal of roentgenology.

[16]  P. McCullough,et al.  Epidemiology of contrast-induced nephropathy. , 2003, Reviews in cardiovascular medicine.

[17]  G. Stone,et al.  Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. , 2005, The American journal of cardiology.

[18]  Diego R Martin,et al.  Risk of nephrogenic systemic fibrosis: evaluation of gadolinium chelate contrast agents at four American universities. , 2008, Radiology.

[19]  Diego R Martin,et al.  Health effects of ionising radiation from diagnostic CT , 2006, The Lancet.

[20]  A. Djamali,et al.  Nephrogenic systemic fibrosis: risk factors and incidence estimation. , 2007, Radiology.

[21]  David W. Johnson,et al.  Is it time to revisit residual renal function in haemodialysis? (Review Article) , 2007, Nephrology.

[22]  T. Frenzel,et al.  Preclinical investigation to compare different gadolinium-based contrast agents regarding their propensity to release gadolinium in vivo and to trigger nephrogenic systemic fibrosis-like lesions , 2008, European Radiology.

[23]  S. Rezkalla,et al.  Contrast nephropathy. , 2003, Clinical medicine & research.

[24]  Raimund Erbel,et al.  Nephrogenic systemic fibrosis: pathogenesis, diagnosis, and therapy. , 2009, Journal of the American College of Cardiology.

[25]  H. Thomsen,et al.  High Prevalence of Nephrogenic Systemic Fibrosis in Chronic Renal Failure Patients Exposed to Gadodiamide, a Gadolinium-Containing Magnetic Resonance Contrast Agent , 2008, Investigative radiology.

[26]  L. Chibnik,et al.  Cutaneous changes of nephrogenic systemic fibrosis: predictor of early mortality and association with gadolinium exposure. , 2007, Arthritis and rheumatism.

[27]  F. Veglia,et al.  Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. , 2004, Journal of the American College of Cardiology.

[28]  C. Viscoli,et al.  The Effect of Acute Renal Failure on Mortality , 1997 .

[29]  E. Fishman,et al.  Radiologists' knowledge and perceptions of the impact of contrast-induced nephropathy and its risk factors when performing computed tomography examinations: a survey of European radiologists. , 2008, European journal of radiology.

[30]  C. Becker,et al.  Epidemiology and prognostic implications of contrast-induced nephropathy. , 2006, The American journal of cardiology.

[31]  S. Cowper,et al.  Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis. , 2007, Journal of the American Academy of Dermatology.

[32]  R. Conetta,et al.  Nephropathy in critically Ill patients without preexisting renal disease. , 2005, Proceedings of the Western Pharmacology Society.

[33]  S. Cowper,et al.  Gadolinium is quantifiable within the tissue of patients with nephrogenic systemic fibrosis. , 2007, Journal of the American Academy of Dermatology.

[34]  H. Thomsen,et al.  Pharmacokinetics of gadodiamide injection in patients with severe renal insufficiency and patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis. , 1998, Academic radiology.

[35]  J. J. Griffin,et al.  Impact of Renal Insufficiency in Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction , 2003, Circulation.

[36]  V. Runge,et al.  Nephrogenic Systemic Fibrosis: A Review of 6 Cases Temporally Related to Gadodiamide Injection (Omniscan) , 2007, Investigative radiology.

[37]  Diego R. Martín,et al.  Response to the FDA's May 23, 2007, nephrogenic systemic fibrosis update. , 2008, Radiology.

[38]  D. Broome,et al.  Nephrogenic systemic fibrosis associated with gadolinium based contrast agents: a summary of the medical literature reporting. , 2008, European journal of radiology.

[39]  Martin R Prince,et al.  Incidence of nephrogenic systemic fibrosis at two large medical centers. , 2008, Radiology.

[40]  H. Thomsen,et al.  Enhanced computed tomography or magnetic resonance imaging: a choice between contrast medium-induced nephropathy and nephrogenic systemic fibrosis? , 2007, Acta radiologica.

[41]  S. H. Kim,et al.  The synthesis and evaluation of macrocyclic gadolinium-DTPA-bis(amide) complexes as magnetic resonance imaging contrast agents. , 1994, Investigative radiology.

[42]  P. Patel,et al.  Gadolinium-containing magnetic resonance imaging contrast and nephrogenic systemic fibrosis: a case-control study. , 2008, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[43]  H. Thomsen,et al.  Is there a causal relation between the administration of gadolinium based contrast media and the development of nephrogenic systemic fibrosis (NSF)? , 2006, Clinical radiology.

[44]  C. Viscoli,et al.  The effect of acute renal failure on mortality. A cohort analysis. , 1996, JAMA.

[45]  T. Grobner Gadolinium--a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis? , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[46]  G. Stone,et al.  Impact of gender on the incidence and outcome of contrast-induced nephropathy after percutaneous coronary intervention. , 2002, The Journal of invasive cardiology.

[47]  C. Wong,et al.  Acute adverse reactions to magnetic resonance contrast media--gadolinium chelates. , 2006, The British journal of radiology.

[48]  R. Johann-Liang,et al.  Safety risks with gadolinium‐based contrast agents , 2007, Journal of magnetic resonance imaging : JMRI.

[49]  D. Tudorascu,et al.  Nephrogenic systemic fibrosis: Center case review , 2007, Journal of magnetic resonance imaging : JMRI.

[50]  Gerald A Kirk,et al.  Gadodiamide-associated nephrogenic systemic fibrosis: why radiologists should be concerned. , 2007, AJR. American journal of roentgenology.

[51]  D. Klippenstein,et al.  Iodixanol: Risk of Subsequent Contrast Nephropathy in Cancer Patients With Underlying Renal Insufficiency Undergoing Diagnostic Computed Tomography Examinations , 2007, Journal of computer assisted tomography.

[52]  T. Frenzel,et al.  Long-term retention of gadolinium in the skin of rodents following the administration of gadolinium-based contrast agents , 2009, European Radiology.