title: Ten-year experience with nephrogenic systemic fibrosis: case-control analysis of risk factors.
abstract: OBJECTIVE
  To analyze all cases of nephrogenic systemic fibrosis (NSF) at our institution and to compare them with controls.
  
  
  METHODS
  After the institutional review board approval, 13 biopsy-proven NSF cases were identified. Ten cases had complete records and were compared in a case-control format with 10 age- and sex-matched, dialysis-dependent controls. Analyzed risk factors included single and cumulative gadolinium dose, medication and transplant history, and serum electrolytes at the time of gadolinium exposure.
  
  
  RESULTS
  There were 1.9% of dialysis-dependent, gadolinium-exposed patients who developed NSF. There was no difference in gadolinium dose, transplant history, or serum electrolytes. Seven of 10 cases and 3 of 10 controls were treated with erythropoietin (P = 0.13). At the time of NSF diagnosis, 7 of 10 cases were on immunosuppressive therapy. Two of 7 cases developed NSF only after immunosuppressive therapy was initiated. Two of 10 controls were on immunosuppressive therapy (P = 0.06).
  
  
  CONCLUSIONS
  All cases of NSF occurred in dialysis-dependent, gadolinium-exposed patients. Associations between immunosuppressive and erythropoietin therapies and NSF need further investigation.
authors: Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, Los Angeles, CA 90095-7437, USA. sbahrami@mednet.ucla.edu
authors: Simin
authors: S
authors: Bahrami
authors: Steven S
authors: SS
authors: Raman
authors: Steven
authors: S
authors: Sauk
authors: Saleh
authors: S
authors: Salehmoghaddam
authors: Juan Pablo
authors: JP
authors: Villablanca
authors: J Paul
authors: JP
authors: Finn
authors: David S K
authors: DS
authors: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D003287:Contrast Media / Q000009:adverse effects*; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005682:Gadolinium / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D054989:Nephrogenic Fibrosing Dermopathy / Q000139:chemically induced* / Q000453:epidemiology / Q000628:therapy; D006435:Renal Dialysis; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D003287:Contrast Media; D007166:Immunosuppressive Agents; D004921:Erythropoietin; D005682:Gadolinium