How is nephrogenic systemic fibrosis diagnosed?
Diagnosis of nephrogenic systemic fibrosis is made with: Physical exam for signs and symptoms of the disease, and evaluation for a possible history of MRI using a gadolinium-based contrast agent when advanced kidney disease is present. A sample of tissue (biopsy) taken from the skin and muscle.
How does gadolinium cause NSF?
What causes nephrogenic systemic fibrosis? Most, if not all, cases of nephrogenic systemic fibrosis are caused by exposure to gadolinium-based contrast agents (GBCA). Exposure occurs when the chemical element gadolinium is used to enhance images gathered in magnetic resonance imaging (MRI).
When does nephrogenic systemic fibrosis occur?
Nephrogenic systemic fibrosis is a rare disease that occurs mainly in people with advanced kidney failure with or without dialysis. Nephrogenic systemic fibrosis may resemble skin diseases, such as scleroderma and scleromyxedema, with thickening and darkening developing on large areas of the skin.
What is NSF with gadolinium?
Nephrogenic systemic fibrosis (NSF) is a rare, potentially fatal condition caused by iatrogenic gadolinium administration in patients with acute kidney injury or stage 4 or 5 chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) of less than 30 mL/min/1.73 m2.
How common is nephrogenic systemic fibrosis?
The incidence of nephrogenic systemic fibrosis was 4.3 cases per 1000 patient-years. Each radiologic study using gadolinium presented a 2.4% risk for developing nephrogenic systemic fibrosis.
How does gadolinium cause nephrogenic systemic fibrosis?
Renal failure increases the duration of the gadolinium exposure through decreased clearance of free gadolinium. This in turn leads to a higher incidence of deposition into tissue, which explains why nephrogenic systemic fibrosis risk may increase with an increased cumulative dose.
How many people have nephrogenic systemic fibrosis?
More than 375 cases have been identified by the NSF Registry. The disorder can affect children, adults or the elderly. It is most common in the middle-aged and no known ethnic or racial predilection exists.
What can cause NSF in MRI?
NSF is caused by exposure to gadolinium in gadolinium-based MRI contrast agents (GBCAs) in patients with impaired kidney function. Epidemiological studies suggest that the incidence of NSF is unrelated to gender or ethnicity and it is not thought to have a genetic basis.
Can gadolinium cause kidney damage?
Gadolinium-containing contrast agents may increase the risk of a rare but serious disease called nephrogenic systemic fibrosis in people with severe kidney failure. Nephrogenic systemic fibrosis triggers thickening of the skin, organs and other tissues.