Dr. Shawn E. Cowper of Yale University and colleagues designed a study to determine the true risk of NSF among kidney disease patients exposed to gadolinium - an element used in Magnetic resonance imaging (MRI) contrast agents such as gadodiamide.
"NSF is a newly recognized and sometimes fatal condition in which the skin becomes stiff, sometimes immobilizing the patient. In addition, internal organ involvement may be seen," Cowper explains.
The researchers reviewed records of all patients receiving dialysis over an 18-month period. Out of 467 patients, three developed NSF - all three had undergone MRI scans using gadolinium within the previous two months. Another 84 dialysis patients received gadolinium but did not develop NSF.
The overall risk of NSF was estimated at 4.3 cases per 1,000 dialysis patients per year. "This means that approximately 1 in 40 gadolinium-based MRI scans resulted in NSF in the renal population," Cowper adds. There was no risk when MRI scans were done without gadolinium. So far, there have been no reported cases of NSF in patients with intact kidney function.
In an editorial, Dr. Mark A. Perazella of Yale University summarizes what little is known about NSF, in light of the increasing evidence of a link to gadolinium. "Despite the paucity of definitive data, the association is so strong, that both the FDA and the company that makes gadodiamide have sent out warnings about the use of gadolinium-containing contrast in patients with advanced kidney disease," he says. Pending further studies, the experts recommend that gadolinium-based MRI scans be avoided in patients with advanced kidney disease.
MEDICA.de; Source: American Society of Nephrology (ASN)