title: Rapid deterioration of renal insufficiency after magnetic resonance imaging with gadolinium-based contrast agent.
abstract: Gadolinium (Gd)-based contrast media were introduced as alternatives to iodinated media for magnetic resonance imaging (MRI). Although originally thought to be non-nephrotoxic, Gd-based contrast media have recently been reported to be associated with acute kidney injury. The underlying mechanism of Gd-induced renal injury is not completely understood. We report an 80-year-old patient with buccal mucosa cancer for whom MRI with Gd-based contrast agent was conducted 3 times within 3 weeks. The patient developed rapid deterioration of preexisting renal insufficiency, and developed uremic symptoms and pulmonary edema. The patient was hemodialyzed 3 times. This resulted in improvement of renal function and clinical symptoms. This case emphasizes the potential nephrotoxicity of Gd-based contrast media and suggests that renal insufficiency, diabetes mellitus, old age and high dose of Gd-based contrast medium are risk factors for acute kidney injury.
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. kiichiro.fujisaki@nifty.ne.jp
authors.forename: K
authors.initials: K
authors.lastname: Fujisaki
authors.forename: A
authors.initials: A
authors.lastname: Ono-Fujisaki
authors.forename: N
authors.initials: N
authors.lastname: Kura-Nakamura
authors.forename: N
authors.initials: N
authors.lastname: Komune
authors.forename: N
authors.initials: N
authors.lastname: Hirakawa
authors.forename: K
authors.initials: K
authors.lastname: Tsuruya
authors.forename: S
authors.initials: S
authors.lastname: Komune
authors.forename: M
authors.initials: M
authors.lastname: Iida
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D019786:Gadolinium DTPA / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009062:Mouth Neoplasms / Q000150:complications / Q000473:pathology*; D011654:Pulmonary Edema / Q000139:chemically induced; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014511:Uremia / Q000139:chemically induced
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA