Nephrogenic systemic fibrosis: What the hospitalist needs to know

Derek M. Fine, Mark A. Perazella

Research output: Contribution to journalArticle

Abstract

Nephrogenic systemic fibrosis (NSF) has now been linked to gadolinium-based contrast (GBC) exposure in those with compromised kidney function, particularly those with end-stage renal disease (ESRD). When ESRD is present, symptoms can be quite devastating for the patient including severe pain and immobility and even death. For those at risk, avoidance of GBC exposure, whenever possible, is absolutely essential to prevent this potentially devastating complication. Identifying those at risk depends in some circumstances on appropriate recognition of renal dysfunction and understanding appropriate use of glomerular filtration rate (GFR) estimation formulas. Although hemodialysis (but not peritoneal dialysis) removes gadolinium, the availability of dialysis should never be used as a justification for GBC use in this high-risk population. Unfortunately there is a lack of a universally effective therapy. Resolution of acute kidney injury (AKI) appears to attenuate disease in most cases, while kidney transplantation has been associated with variable success.

Original languageEnglish (US)
Pages (from-to)46-50
Number of pages5
JournalJournal of hospital medicine
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Contrast
  • Diagnosis
  • Gadolinium
  • Nephrogenic fibrosing dermopathy
  • Nephrogenic systemic fibrosis

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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