Nephrogenic systemic fibrosis: UK survey of the use of gadolinium-based contrast media.
OBJECTIVE
To identify the current practice of administration of gadolinium-based contrast media (Gd-CM) within the UK with respect to the European Society of Urogenital Radiology (ESUR) guidelines on nephrogenic systemic fibrosis (NSF).


METHODS
One hundred and fifty-two institutions were contacted to request details regarding the use of Gd-CM at their institution, their awareness of NSF, and of the ESUR guidelines, and their departmental policy on the administration of Gd-CM agents associated with NSF (high-risk agents) in patients with diminished renal function.


RESULTS
Of the 100 institutions that replied, 72% used a cyclic agent as a first-line Gd-CM. The majority of institutions used more than one Gd-CM, and 57% used a high-risk Gd-CM. Seventy percent were aware of the ESUR guidelines, and of the 57% that used a high-risk Gd-CM, 9% did not check renal function at all prior to administration. The course of action of the remaining 48% was varied in patients with diminished renal function with some changing to a low-risk Gd-CM and others electing not to use Gd-CM at all. Five percent continued to use a high-risk Gd-CM with an estimated glomerular filtration rate <30ml/min.


CONCLUSIONS
The present survey shows that the majority of institutions use a low-risk Gd-CM as a first-line agent; however, a number of institutions do use a high-risk Gd-CM and their course of action for patients with diminished renal function is varied. Given current evidence, it is advisable to use a low-risk Gd-CM, such as a cyclic agent, in patients with diminished renal function.
Rees
O
O
Wrexham Maelor Hospital, Wrexham, UK. owenrees1@gmail.com
Agarwal
S K
SK
D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005682:Gadolinium / Q000009:adverse effects*; D005919:Glomerular Filtration Rate; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D009313:National Health Programs / Q000592:standards; D054989:Nephrogenic Fibrosing Dermopathy / Q000139:chemically induced*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D006113:United Kingdom
D003287:Contrast Media; D005682:Gadolinium