Issues with MRI Contrast Agents

Recent research has discovered a disturbing issue that has arisen with the use of MRI contrast agents containing Gadolinium. A side effect of using the contrast agents could cause a excruciating disfiguring condition in patients with advanced kidney disease or kidney failure. The condition is called Nephrogenic Systemic Fibrosis and is observed in these patients after they have received a gadolinium based magnetic resonance imaging (MRI) contrast agent.

Gadolinium is a metal ion with magnetic properties. Because the ion tends to move into magnetic fields, Gadolinium is very useful when used in conjunction with an MRI. The solution containing the Gadolinium is injected into the vein prior to the MRI and enhances the images of the internal organs for the radiologist. A gadolinium based MRI contrast agent assists the radiologist in identifying abnormal tissue and cancerous growths. A contrast agent containing Gadolinium is not required for an MRI, but images taken after the agent is injected are much more detailed than images taken without.

Recent studies have linked the development of Nephrogenic Systemic Fibrosis in patients with advanced kidney disease and kidney failure to a prior injection of a gadolinium based MRI contrast agent. The condition causes the formation of coarse, rigid areas of skin that tightens and restricts the movement of the joints. Nephrogenic Systemic Fibrosis can also spread to the internal organs of the body, becoming fatal quickly. Many individuals diagnosed with Nephrogenic Systemic Fibrosis lose all mobility and become bedridden or confined to a wheelchair.
Nephrogenic Systemic Fibrosis is characterized by rough, tight patches of skin that resembles the peel of an orange. Patients suffering from the condition report a severe itching, burning sensation in the skin and generalized muscle weakness. As the skin tightens, it restricts the movement of the joints to the point where attempted movement could cause the breakage of a bone. The condition is typically restricted to the arms, legs, hands, and feet, but in rare cases, it can affect the trunk of the body as well.

There are five gadolinium based MRI contrast agents that were approved by the US Food and Drug Administration that could potentially cause the development of Nephrogenic Systemic Fibrosis. They were all approved between 1988 and 2004. The first cases of Nephrogenic Systemic Fibrosis were discovered in 1997 and the first medical references about the condition were written in 2000. Not much is known about the disorder due to its fairly recent origination, but researchers continue to study the condition to learn all that they can. There is no cure available for Nephrogenic Systemic Fibrosis and many treatments are ineffective against the progression of the disorder.

There are close to 300 confirmed cases of Nephrogenic Systemic Fibrosis reported worldwide. In the cases researched by the US Food and Drug Administration, all of the patients had received an injection of a contrast agent containing Gadolinium in the 2 days to 18 months prior to the onset of the condition. The US Food and Drug Administration issued an alert to the healthcare community warning of the increased risk to patients with advanced kidney disease and kidney failure. About 3% of individuals with advanced kidney disease or kidney failure who are given a contrast agent containing Gadolinium will develop Nephrogenic Systemic Fibrosis.