Nephrogenic Systemic Fibrosis in Patients with Chronic Kidney Disease after the Use of Gadolinium-Based Contrast Agents: A Review for the Cardiovascular Imager
Sebastian Gallo-Bernal,
Nasly Patino-Jaramillo,
Camilo A. Calixto,
Sergio A. Higuera,
Julian F. Forero,
Juliano Lara Fernandes,
Carlos Góngora,
Michael S. Gee,
Brian Ghoshhajra,
Hector M. Medina
Affiliations
Sebastian Gallo-Bernal
Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
Nasly Patino-Jaramillo
Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia
Camilo A. Calixto
Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
Sergio A. Higuera
Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia
Julian F. Forero
Division of Radiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia
Juliano Lara Fernandes
Jose Michel Kalaf Research Institute, Radiologia Clinica de Campinas, São Paulo 13092-123, Brazil
Carlos Góngora
Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
Michael S. Gee
Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
Brian Ghoshhajra
Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
Hector M. Medina
Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia
Gadolinium-enhanced cardiac magnetic resonance has revolutionized cardiac imaging in the last two decades and has emerged as an essential and powerful tool for the characterization and treatment guidance of a wide range of cardiovascular diseases. However, due to the high prevalence of chronic renal dysfunction in patients with cardiovascular conditions, the risk of nephrogenic systemic fibrosis (NSF) after gadolinium exposure has been a permanent concern. Even though the newer macrocyclic agents have proven to be much safer in patients with chronic kidney disease and end-stage renal failure, clinicians must fully understand the clinical characteristics and risk factors of this devastating pathology and maintain a high degree of suspicion to prevent and recognize it. This review aimed to summarize the existing evidence regarding the physiopathology, clinical manifestations, diagnosis, and prevention of NSF related to the use of gadolinium-based contrast agents.
