STATE-OF-THE-ART PAPER
Nephrogenic Systemic FibrosisPathogenesis, Diagnosis, and Therapy
Andreas Kribben, MD*,*,
Oliver Witzke, MD*,
Uwe Hillen, MD ,
Jörg Barkhausen, MD ,
Anton E. Daul, MD|| and
Raimund Erbel, MD
* Department of Nephrology, University Duisburg-Essen, Essen, Germany
Department of Dermatology, University Duisburg-Essen, Essen, Germany
Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Duisburg-Essen, Essen, Germany
Department of Cardiology, University Duisburg-Essen, Essen, Germany
|| Department of Internal Medicine, Division of Nephrology, Elisabeth Hospital Essen, Essen, Germany
Manuscript received August 11, 2008;
revised manuscript received December 3, 2008,
accepted December 8, 2008.
* Reprint requests and correspondence: Dr. Andreas Kribben, Department of Nephrology, University Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany (Email: andreas.kribben{at}uni-due.de).
Nephrogenic systemic fibrosis (NSF) is a newly recognized disorder occurring exclusively in patients with renal failure. Exposure to gadolinium-based magnetic resonance (MR) contrast media has been associated with subsequent development of NSF. Nephrogenic systemic fibrosis is characterized by skin induration preferentially affecting the extremities. In addition, involvement of internal organs occurs, which leads ultimately to death. Skin biopsy is important for confirmation of the diagnosis. The main therapeutic goal is restoration of renal function. To reduce the risk of NSF, renal function must be determined before exposure to gadolinium-containing MR contrast agents. Gadolinium-based MR contrast media should be avoided in the presence of advanced renal failure with estimated glomerular filtration rate below 30 ml/min/1.73 m2, unless the diagnostic information is essential and not available with noncontrast magnetic resonance imaging techniques. The recommended dose of contrast agent should not be exceeded. In addition, a sufficient period of time for elimination of the contrast agent from the body should be allowed before readministration of the contrast agent.
Key Words: gadolinium magnetic resonance imaging nephrogenic systemic fibrosis renal failure
|
Abbreviations and Acronyms
| | AKI = acute kidney injury | | CKD = chronic kidney disease | | FDA = Food and Drug Administration | | GFR = glomerular filtration rate | | MRA = magnetic resonance angiography | | MRI = magnetic resonance imaging | | NSF = nephrogenic systemic fibrosis |
|
Related Article
-
Inside This Issue
J. Am. Coll. Cardiol. 2009 53: A24.
[Full Text]
[PDF]
This article has been cited by other articles:

|
 |

|
 |
 
D. W. den Uijl, V. Delgado, M. Bertini, L. F. Tops, S. A. Trines, N. R. van de Veire, K. Zeppenfeld, M. J. Schalij, and J. J. Bax
Impact of left atrial fibrosis and left atrial size on the outcome of catheter ablation for atrial fibrillation
Heart,
November 15, 2011;
97(22):
1847 - 1851.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Endorsed by: the European Stroke Organisation (ESO, Authors/Task Force Members, M. Tendera, V. Aboyans, M.-L. Bartelink, I. Baumgartner, D. Clement, J.-P. Collet, A. Cremonesi, M. De Carlo, et al.
ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries * The Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC)
Eur. Heart J.,
November 2, 2011;
32(22):
2851 - 2906.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. R. Kalisz, A. H. Davarpanah, A. A. Usman, J. D. Collins, T. J. Carroll, and J. C. Carr
Detection of Renal Dysfunction by Point-of-Care Creatinine Testing in Patients Undergoing Peripheral MR Angiography
Am. J. Roentgenol.,
August 1, 2011;
197(2):
430 - 435.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Perazzolo Marra, J. A. C. Lima, and S. Iliceto
MRI in acute myocardial infarction
Eur. Heart J.,
February 1, 2011;
32(3):
284 - 293.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. A. Figtree, J. Lonborg, S. M. Grieve, M. R. Ward, and R. Bhindi
Cardiac Magnetic Resonance Imaging for the Interventional Cardiologist
J. Am. Coll. Cardiol. Intv.,
February 1, 2011;
4(2):
137 - 148.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Blankstein and A. D. DeVore
Selecting a Noninvasive Imaging Study After an Inconclusive Exercise Test
Circulation,
October 12, 2010;
122(15):
1514 - 1518.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
N. Lameire, J. Floege, and D. C. Wheeler
The five most cited NDT papers from 2005 to 2009
Nephrol. Dial. Transplant.,
September 1, 2010;
25(9):
2825 - 2831.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. Abdel-Kader, P. R. Patel, A. J. Kallen, R. L. Sinkowitz-Cochran, W. K. Bolton, and M. L. Unruh
Nephrogenic Systemic Fibrosis: A Survey of Nephrologists' Perceptions and Practices
Clin. J. Am. Soc. Nephrol.,
June 1, 2010;
5(6):
964 - 971.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Stratta, C. Canavese, M. Quaglia, and R. Fenoglio
Gadolinium-associated nephrogenic systemic fibrosis in patients with renal failure: the need for an interdisciplinary helping network
Rheumatology,
April 1, 2010;
49(4):
821 - 823.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, G. K. Feld, B. H. Greenberg, J. Hall, M. Hlatky, W. Y.W. Lew, J. A.C. Lima, A. S. Maisel, et al.
Highlights of the Year in JACC 2009
J. Am. Coll. Cardiol.,
January 26, 2010;
55(4):
380 - 407.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. W. Kim, A. Farzaneh-Far, and R. J. Kim
Cardiovascular Magnetic Resonance in Patients With Myocardial Infarction: Current and Emerging Applications
J. Am. Coll. Cardiol.,
January 5, 2010;
55(1):
1 - 16.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. J. Glassock, R. Pecoits-Filho, and S. H. Barberato
Left Ventricular Mass in Chronic Kidney Disease and ESRD
Clin. J. Am. Soc. Nephrol.,
December 1, 2009;
4(Supplement_1):
S79 - S91.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. R. Prince, H. L. Zhang, J. C. Prowda, M. E. Grossman, and D. N. Silvers
Nephrogenic Systemic Fibrosis and Its Impact on Abdominal Imaging
RadioGraphics,
October 1, 2009;
29(6):
1565 - 1574.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|