Abstract

Gadolinium based contrast agents (GBCAs) have been linked to nephrogenic systemic fibrosis (NSF) in patients with severe renal dysfunction. This article reviews strategies to prevent this condition in patients at risk. These include administering only single dose GBCA, scheduling MRI for just before the next routine dialysis in dialysis patients, delaying GBCA in acute renal failure while serum creatinine is rising, and making sure the best technologist is doing the case to ensure it will not need repeating. Most MRI centers have implemented at least some these NSF risk reduction strategies and as a result, NSF incidence is markedly decreased.

Keywords: Gadolinium, nephrogenic systemic fibrosis, kidney disease, magnetic resonance imaging, contrast agents, magnetic resonance angiography