New Study Links Gadolinium to NSF in Kidney Patients

Washington, DCNew evidence suggests a causal link between Gadolinium Based Contrast agents—(GBCA, routinely used in MRI procedures)—and nephrogenic systemic fibrosis (NSF) in patients with advanced kidney disease. While the risk for complications from Gadolinium MRI scans have long been suspected, this latest data supports a Gadolinium-NSF link.

According to a recent report in Nephrology Dialysis Transplantation, a medical paper, researchers at the University of Pennsylvania performed a meta-analysis of previous controlled studies examining the association between GBCAs and NSF.

Their observations found that the emergence of NSF was 27 times more likely in patients exposed to gadolinium as compared with those with no exposure.

The review focused on patients with advanced kidney disease.

Gadolinium-based contrast agents are often used in association with MRI procedures in order to give doctors and technicians a clearer, and more definitive, image necessary for the reliable diagnosis of disease and to pinpoint tumors. While gadolinium is not found naturally in the human body, it has been generally believed that the risk to the patient is minimal given the capacity for the kidneys to flush foreign substances out of the human body.

So long as gadolinium isn't allowed to tarry too long in the human body and is excreted in a timely manner, concern has been minimal.

However in patients with under-performing kidneys the potential exists for GBCA to remain in the human body for longer periods, heightening the risk for NSF. There is no cure.

Nephrogenic fibrosing dermopathy was first identified in 1997, so it hasn't been around for much longer than a decade. NSF is characterized by increased deposits of collagen in tissue that results in thickening and hardening of the skin. This, in turn, can severely restrict movement of the joints.

Patients with NSF have been known to become wheelchair-bound within a matter of weeks. NSF has been described by patients as being a living hell. They liken the condition to being entombed in the their own body.

A survey conducted in spring 2007 revealed that out of 100 NSF patients surveyed, 95 were exposed to gadolinium based contrasting agents 2 to 3 months before the onset of their disease. Researchers have also determined that gadolinium can linger in the skin for up to a year after the GBCA was initially administered for treatment, although it is also noted that it takes some time for the gadolinium to get into the skin in the first place.

Thus, the importance to flush the agent completely from the body as soon as possible following an MRI procedure. For patients with weak or compromised kidneys the recommendation is for immediate dialysis when a GBCA is used in order to avoid a gadolinium-NSF link.

In the 2009 review, researchers used four studies where gadodiamide was the sole or predominate GBCA. One study focused on gadopentetae, while the remaining two studies did not specify the agents administered.

In their findings, Rajender Agarwal, MD and his colleagues at the University of Pennsylvania found a significant association demonstrated in 6 of the 7 studies, a clear temporal relationship found in all but one study and a dose-response relationship shown in three.

Their meta-analysis concluded that it is biologically plausible for GBCAs to cause NSF. What's more, the researchers found that gadodiamide was both detectable and quantifiable in the tissues of patients suffering from NSF.

"Our analyses suggest a potent and significant association between GBCAs and NSF among patients with advanced [kidney disease]."

Gadolinium based contrast agents, while routine for magnetic resonance imaging in association with a gadolinium MRI scan, can prove to be life-altering and potentailly fatal for patients with weak or compromised kidneys. If you or a loved one has been affected in this way, a GBCA lawyer could assist you.