Cornell Study Defines Broad Spectrum of Patients at Risk for Development of Gadolinium-Induced Complications

A September of 2008 study published in the journal Radiology, sought to further identify those patients most at risk for the development of nephrogenic systemic fibrosis (NSF) as a result of exposure to gadolinium-based contrast agents.  Nephrogenic systemic fibrosis is an incurable, devastating disease that manifests itself as significant skin thickening, widespread fibrosis, and joint contractures.  This particular disease has only one cause – contrast agents commonly used in magnetic resonance imaging (MRIs) and angiograms.

In this study, the researchers reviewed medical records for nearly 75,000 patients treated at two hospitals over a ten-year period. The study noted that standard lab measurements of renal function were helpful in identifying patients most at risk for development of NSF.  Patients with a glomerular filtration rate (eGFR) of less than 15 were at highest risk, although NSF cases were also noted in patients with eGFR scores as high as 30.  This study is consistent with others that have confirmed that a wide range of patients are at risk for development of NSF, not just those patients with advanced renal failure.  The study noted that a shocking 8.8% of patients with an eGFR of less than 15 (and not undergoing dialysis) developed NSF. The study also concluded that patients receiving the highest doses of gadolinium faced the highest risks of developing NSF .