Gadolinium, MRIs, Renal failure and Nephrogenic systemic fibrosis

Nephrogenic systemic fibrosis (NSF) is a rare but a serious disease that involves fibrosis of skin, joints, eyes, and internal organs. It is found to be associated with exposure to gadolinium for MRIs in patients with severe kidney failure. It can happen anywhere from few hours to months after exposure.

NSF is a clinical and histopathological diagnosis. Most patients with NSF require quick diagnosis and aggressive hemodialysis. Gadolinium-containing contrast is now considered relatively contraindicated in patients with an estimated GFR under 60 and especially under 30 ml/mn.

Not all but 4 of the 7 gadolinium contrast agents have been implicated in NSF.