NSF Risk From Gadolinium Highest for Dialysis, Kidney Transplant Patients
What is Nephrogenic Systemic Fibrosis (NSF)?
Nephrogenic Systemic Fibrosis (NSF), formerly known as nephrogenic fibrosing dermopathy (NFD), is a condition that, to date, has occurred only in people with kidney disease. NSF is a systemic disorder with its most prominent and visible effects in the skin, hence its original designation as a dermopathy (dermopathy=disorder of skin). With the further clarification of hundreds of additional cases and the continued recognition that kidney disease seems to be a prerequisite for developing NSF (nephrogenic=starting with the kidney), NSF has been accepted as the terminology most reflective of the reality of the disorder.
NSF & Gadolinium
On June 8, 2006 the FDA issued a public health advisory to alert medical professionals about the possible link between gadolinium-based contrast agents (GBCAs) and NSF. According to the alert, 25 cases of NSF were reported in patients with kidney failure. On May 23, 2007, the FDA issued an updated statement asking manufacturers of gadolinium-based contrast agents to include a black box warning on their products and a new Warnings sections to their labels to describe the risk of developing NSF.
NSF connected to Kidney Transplant
A study of patients exposed to gadolinium contrast dyes at the Mayo Clinic has revealed that hemodialysis patients had a 77-fold higher risk of developing nephrogenic systemic fibrosis, while kidney transplant patients had a 69-fold higher risk of the disease. The NSF study was published in the October issue of the Archives of Dermatology.
The Mayo Clinic study involved 94,917 patients exposed to gadolinium agents at the Mayo Clinic between January 1, 1999 and December 31, 2006. Of that group, 3,779 patients were on hemodialysis, 1,694 patients had undergone a kidney transplant, and 717 patients had liver transplants. A total of 61 patients had a clinical diagnosis of NSF. The study authors advocated for the development of new guidelines for the administration of gadolinium agents.