Extracellular Gd-CA: differences in prevalence of NSF.
Until recently it was believed that extracellular gadolinium-based contrast agents were safe for both the kidneys and all other organs within the dose range up to 0.3 mmol/kg body weight. However, in 2006, it was demonstrated that some gadolinium-based contrast agents may trig the development of nephrogenic systemic fibrosis, a generalized fibrotic disorder, in renal failure patients. As no prospective studies can be performed we must rely on retrospective data. From those data it is obvious that the prevalence of NSF is significantly higher after the unstable agent gadodiamide than after any other gadolinium-based agent (3-7% versus 0-1% per injection) in patients with reduced renal function. Prevalence after exposure to two gadodiamide injections is as high as 36% in patients with chronic kidney disease (CKD) stage 5. No report of NSF after the most stable agents has been reported in the peer-reviewed literature documenting that there is a difference between the various agents regarding triggering NSF.
Thomsen
Henrik S
HS
Department of Diagnostic Radiology, Copenhagen University Hospital, Herlev, Herlev Ringvej 75, DK-2730 Herlev, Denmark. hentho01@heh.regionh.dk
Marckmann
Peter
P
D016907:Adverse Drug Reaction Reporting Systems; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005355:Fibrosis / Q000139:chemically induced / Q000453:epidemiology; D005682:Gadolinium / Q000008:administration & dosage / Q000009:adverse effects*; D019786:Gadolinium DTPA / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D015995:Prevalence; D012042:Registries; D012871:Skin Diseases / Q000139:chemically induced* / Q000453:epidemiology
D003287:Contrast Media; C064925:gadodiamide; D005682:Gadolinium; D019786:Gadolinium DTPA