title: Are gadolinium-based contrast media nephrotoxic? A renal biopsy study.
abstract: Gadolinium-based contrast media were originally introduced as alternatives to iodinated media for magnetic resonance imaging. Although originally thought to be nonnephrotoxic, gadolinium-based contrast media have recently been reported to be associated with acute renal failure; the mechanism and the underlying renal injury are not completely understood. We report what is, to our knowledge, the first renal biopsy in this context. A 56-year-old patient underwent 2 consecutive vascular imaging procedures in conjunction with gadolinium-based contrast medium administration. A few days later, the patient developed acute renal failure. A renal biopsy showed acute tubular cell injury including patchy tubular cell necrosis, tubular cell degeneration, and marked proliferation of tubular cells, together with mild interstitial edema and interstitial inflammation, but without significant glomerular or vascular changes. During supportive therapy, renal function was partially regained. This case emphasizes the potential nephrotoxicity of gadolinium-based contrast media and suggests that the nephrotoxicity is related to potentially reversible acute tubular cell injury.
authors.affiliation: Departments of Pathology, Nephropathology Service, The Methodist Hospital, Houston, TX 77030, USA.
authors.forename: Hulya
authors.initials: H
authors.lastname: Akgun
authors.forename: Gulfiliz
authors.initials: G
authors.lastname: Gonlusen
authors.forename: Joiner
authors.initials: J
authors.lastname: Cartwright
authors.forename: Wadi N
authors.initials: WN
authors.lastname: Suki
authors.forename: Luan D
authors.initials: LD
authors.lastname: Truong
mesh_terms: D001706:Biopsy; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D005682:Gadolinium / Q000009:adverse effects*; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000473:pathology*; D007680:Kidney Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D004369:Pentetic Acid / Q000009:adverse effects*
chemical_list: D003287:Contrast Media; D004369:Pentetic Acid; D005682:Gadolinium; D003404:Creatinine