Revisiting nephrogenic systemic fibrosis in 6 kidney transplant recipients: A single-center experience

Lemy, Anne; Marmol, Véronique Del; Kolivras, Athanassios; High, Whitney A.; Matos, Celso; Laporte, Marianne; Nortier, Joëlle

doi:10.1016/j.jaad.2009.10.038

Cited by 12 publications

(3 citation statements)

References 41 publications

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“…The interval between GBCA exposure and NSF was available for 336 patients, ranging from the same day to approximately 10 years (median, 42 days; mode, 30 days; interquartile range, 19-90 days). For patients in whom GBCA dose was reported or could be estimated from the examination type, 6.7% (19 of 282) of patients were administered a standard dose (0.1 mmol/kg) or lower, and 93.3% (263 of 282) (23). Another patient in the same study improved by switching from subcutaneous administration of darbepoetin to intravenous administration of darbepoetin.…”

Section: Type Of Mri-mri Examination Typementioning

confidence: 99%

A Systematic Review of 639 Patients with Biopsy-confirmed Nephrogenic Systemic Fibrosis

et al. 2019

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Background: Although nephrogenic systemic fibrosis (NSF) affects the use of gadolinium-based contrast agents (GBCAs) in MRI, there continues to be limited knowledge because of the small number of patients with NSF. Purpose: To perform a systematic review of NSF. Materials and Methods: PubMed database was searched by using the term "Nephrogenic systemic fibrosis" from January 2000 to February 2019. Articles reporting details on individual patients with NSF diagnosis on the basis of both clinical presentations and biopsy confirmation were included. Data were pooled and authors were contacted for clarifications. Rates of NSF were compared through 2008 versus after 2008 and for group I versus group II GBCAs, assuming equal market share. Results: Included were 639 patients from 173 articles. Data regarding sex were found for 295 men and 254 women. Age at NSF symptom onset was reported for 177 patients (mean, 49 years 6 16 [standard deviation]; age range, 6-87 years). There were 529 patients with documented exposure to GBCAs including gadodiamide (n = 307), gadopentetate dimeglumine (n = 49), gadoversetamide (n = 6), gadobutrol (n = 1), gadobenate dimeglumine (n = 1), multiple (n = 41), and unknown (n = 120). Among patients with previous exposure, only seven patients were administered GBCA after 2008, yielding a lower rate of NSF after 2008 (P , .001). There were motion limitations in 70.8% (296 of 418) of patients, indicating a more serious debilitation. Associated factors reported for NSF included exposure to GBCA group I (P , .001), dialysis, proinflammatory conditions, hyperphosphatemia, bblockers, and epoetin. For 341 patients with follow-up, 12 patients were cured and 72 patients partially improved including one during pregnancy. Among those 84 patients reported as cured or improved, in 34 patients cure or improvement occurred after renal function restoration. Four deaths were attributed to NSF. Conclusion: Although 639 patients with biopsy-confirmed nephrogenic systemic fibrosis were reported, only seven were after gadolinium-based contrast agent exposure after 2008, indicating that regulatory actions and practice changes have been effective preventive measures. Improvement and sometimes cure with renal function restoration are now possible.

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Section: Type Of Mri-mri Examination Typementioning

confidence: 99%

A Systematic Review of 639 Patients with Biopsy-confirmed Nephrogenic Systemic Fibrosis

et al. 2019

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“…They also reported that patients with renal disease, who were exposed to gadolinium‐containing contrast agents and developed NSF, were acidotic at the time of imaging, while those who did not develop NSF were not. NSF can also develop in kidney transplant recipients with altered graft function . Marckmann et al studied 13 cases of NSF and calculated an odds ratio of 32.5 (95% confidence interval 1.9–549.2; p < 0.0001) for development of NSF after exposure to gadodiamide.…”

mentioning

confidence: 99%

Time‐dependent decrement of dermal gadolinium deposits and significant improvement of skin symptoms in a patient with nephrogenic systemic fibrosis after temporary renal failure

Schäd

Heitland²,

Kühn‐Velten³

et al. 2013

J Cutan Pathol

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“…Definitive diagnosis of NSF requires deep skin biopsy and histopathological examination. A recently published study by Lemy et al showed that of 33 patients with kidney transplant exposed to Gd-CM, five (15.2%) developed NSF [47]. The relative risk for NSF development in patients with endstage renal disease (ESRD) in those who underwent gadolinium-enhanced MRI compared with those who did not was recently reported to be 44.74 [48].…”

Section: Discussionmentioning

confidence: 99%

Incidence of nephrogenic systemic fibrosis at a large university hospital in Sweden

Alhadad

Sterner

Svensson

et al. 2011

Scandinavian Journal of Urology and Nephrology

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Objective. Nephrogenic systemic fibrosis (NSF) is a rare condition that may follow administration of gadolinium-based contrast media (Gd-CM) in patients with renal insufficiency. This study was initiated to determine the incidence of NSF at Skåne University Hospital, Malmö, in Sweden. Material and methods. During the period January 2001 to December 2008 10 650 patients underwent magnetic resonance imaging (MRI) examinations. The re-expressed four-variable Modification of Diet in Renal Disease (MDRD) equation was used to calculate the estimated glomerular filtration rate (eGFR). The 272 patients with an eGFR <30 ml/min/1.73 m2 who were given Gd-CM were selected for final analysis. A diagnosis of NSF or other dermatological diagnoses in the 272 patients was searched for in the database of the Departments of Dermatology and Pathology. Results. The 272 patients, of whom 26 patients were on dialysis, had undergone 406 MRI examinations with Gd-CM. Mean follow-up time was 3.9 (±2.7 SD) years. Assuming a mean body weight of 70 kg, the overall median dose of the 406 examinations with Gd-CM was 0.14 mmol/kg body weight (0.06, 0.34; 2.5-97.5 percentiles). In this retrospective study of patients with eGFR <30 ml/min/1.73 m 2 , none developed NSF (the upper 95% confidence limit for zero cases of NSF in the 272 patients was 2.3%). Conclusion. Although it is premature to claim that Gd-CM using the regimen employed in this institution is safe to use in all patients with eGFR <30 ml/min/1.73 m 2 , the results.indicate that development of NSF is extremely uncommon.

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Revisiting nephrogenic systemic fibrosis in 6 kidney transplant recipients: A single-center experience

Abstract: Background: Nephrogenic systemic fibrosis (NSF) is a fibrotic disorder occurring in patients with renal dysfunction. Exposure to gadolinium (Gd)-based contrast agents (GBCAs) during renal impairment is associated with development of NSF.

Cited by 12 publications

References 41 publications

A Systematic Review of 639 Patients with Biopsy-confirmed Nephrogenic Systemic Fibrosis

A Systematic Review of 639 Patients with Biopsy-confirmed Nephrogenic Systemic Fibrosis

Time‐dependent decrement of dermal gadolinium deposits and significant improvement of skin symptoms in a patient with nephrogenic systemic fibrosis after temporary renal failure

Incidence of nephrogenic systemic fibrosis at a large university hospital in Sweden

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