title: Gadobenate Dimeglumine Administration and Nephrogenic Systemic Fibrosis: Is There a Real Risk in Patients with Impaired Renal Function?
abstract: OBJECTIVE
  To determine the incidence of nephrogenic systemic fibrosis (NSF) in patients with renal disease who received gadobenate dimeglumine at a single medical center.
  
  
  METHODS
  This was an institutional review board-approved HIPAA-compliant retrospective study with waiver of informed consent. Patients either underwent dialysis or not, had an abnormal estimated glomerular filtration rate (eGFR), and underwent magnetic resonance (MR) imaging and/or MR angiography with gabobenate dimeglumine in 2010. Dialysis status, eGFR, time to transplantation, waiting list status, contrast material volume at index imaging, and additional imaging examinations between 2007 and 2014 were recorded. Clinical notes with and without integument examinations, pathologic records, and additional patient communication were evaluated for development of NSF through September 2014. Dates of latest documented integument examination and latest interaction were recorded. Mean, standard deviation, and median values were obtained, along with incidence percentage of NSF.
  
  
  RESULTS
  Of 401 patients (172 women, 229 men; mean age, 50 years), 75.5% were dialysis dependent (n = 303) and 24.4% (n = 98) were not undergoing dialysis, with a mean eGFR ± standard deviation of 17 mL/min per 1.73 m(2) ± 5.6 (range, 6-41 mL/min per 1.73 m(2); median, 16.3 mL/min per 1.73 m(2)). Mean and median contrast material volume at index imaging were 24 mL ± 5.7 (range, 9-45 mL). Additional contrast material volume administered was 23 mL ± 12.9 (range, 6-64 mL; median, 20 mL; n = 66). One hundred twenty-six patients (31%) received a transplant; mean time to transplantation was 1.72 years ± 1.25 (range, 0-4.46 years; median, 1.4 years). No patients received diagnoses of NSF. Mean follow-up was 2.35 years ± 1.61 (range, 0.00-4.61 years; median, 2.75 years) with documented integument examination and 3.08 years ± 1.36 (range, 0.16-4.66 years; median, 3.66 years) with direct patient communication.
  
  
  CONCLUSIONS
  No patients undergoing peritoneal dialysis, hemodialysis, or nondialysis who experienced renal failure developed NSF after administration of gadobenate dimeglumine after more than 2 years' mean follow-up. Gadobenate dimeglumine may be safe in this population.
authors: From the Department of Radiology, Emory University, 1364 Clifton Rd NE, Atlanta, GA 30322.
authors: Sadhna B
authors: SB
authors: Nandwana
authors: From the Department of Radiology, Emory University, 1364 Clifton Rd NE, Atlanta, GA 30322.
authors: Courtney C
authors: CC
authors: Moreno
authors: From the Department of Radiology, Emory University, 1364 Clifton Rd NE, Atlanta, GA 30322.
authors: Michael T
authors: MT
authors: Osipow
authors: From the Department of Radiology, Emory University, 1364 Clifton Rd NE, Atlanta, GA 30322.
authors: Aarti
authors: A
authors: Sekhar
authors: From the Department of Radiology, Emory University, 1364 Clifton Rd NE, Atlanta, GA 30322.
authors: Kelly L
authors: KL
authors: Cox
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008536:Meglumine / Q000009:adverse effects / Q000031:analogs & derivatives*; D008875:Middle Aged; D054989:Nephrogenic Fibrosing Dermopathy / Q000139:chemically induced* / Q000453:epidemiology*; D009942:Organometallic Compounds / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000150:complications*; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine