title: Current status of nephrogenic systemic fibrosis.
abstract: Nephrogenic systemic fibrosis (NSF) occurs in patients with advanced chronic kidney disease (CKD) or acute renal failure, most commonly following exposure to gadolinium-based contrast agents (GBCAs). NSF can be debilitating and associated with increased mortality. The putative association of NSF with GBCAs prompted the development of guidelines to limit the use of these contrast agents in at-risk patients. Indeed, the incidence of NSF has decreased dramatically following application of these guidelines, which appears to be the only effective means of decreasing NSF incidence. Thus, increasing clinician awareness of these updated guidelines is important. The present review introduces and compares updated guidelines for GBCA use and discusses the latest advances in the understanding of the pathogenic mechanisms and treatment of NSF.
authors.affiliation: Radiology Department, Massachusetts General Hospital, Harvard Medical School, USA.
authors.forename: L
authors.initials: L
authors.lastname: Daftari Besheli
authors.affiliation: Radiology Department, Massachusetts General Hospital, Harvard Medical School, USA.
authors.forename: S
authors.initials: S
authors.lastname: Aran
authors.affiliation: Radiology Department, Massachusetts General Hospital, Harvard Medical School, USA.
authors.forename: K
authors.initials: K
authors.lastname: Shaqdan
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, MA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Kay
authors.affiliation: Radiology Department, Massachusetts General Hospital, Harvard Medical School, USA. Electronic address: habujudeh@partners.org.
authors.forename: H
authors.initials: H
authors.lastname: Abujudeh
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D016207:Cytokines / Q000187:drug effects; D004812:Epidemiologic Methods; D005682:Gadolinium / Q000008:administration & dosage / Q000009:adverse effects*; D019983:Guideline Adherence; D006801:Humans; D054989:Nephrogenic Fibrosing Dermopathy / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced
chemical_list: D003287:Contrast Media; D016207:Cytokines; D005682:Gadolinium