Author + information
- Received August 11, 2008
- Revision received December 3, 2008
- Accepted December 8, 2008
- Published online May 5, 2009.
- Andreas Kribben, MD*,* (, )
- Oliver Witzke, MD*,
- Uwe Hillen, MD†,
- Jörg Barkhausen, MD‡,
- Anton E. Daul, MD∥ and
- Raimund Erbel, MD§
- ↵*Reprint requests and correspondence:
Dr. Andreas Kribben, Department of Nephrology, University Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany
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.
The subject of this article is independently presented, and the depiction of contents is presented with product neutrality. Dr. Kribben has received lecture fees from Bayer Schering AG and GE Healthcare Buchler (Amersham). Dr. Barkhausen has received speaker honorarium from Bayer, Covidien, and Guerbet, and grant support from Bayer and Guerbet.
- Received August 11, 2008.
- Revision received December 3, 2008.
- Accepted December 8, 2008.
- American College of Cardiology Foundation