Nephrogenic systemic fibrosis may resemble skin diseases, such as scleroderma and scleromyxedema, with thickening and darkening developing on large areas of the skin.
The Food and Drug Administration (FDA) recommends not using gadolinium-containing contrast agents in people with acute kidney injury or chronic kidney disease. The highest risk of nephrogenic systemic fibrosis after gadolinium exposure occurs in people who:
This increased risk is thought to be related to the reduced ability of these people's kidneys to remove the contrast agent from the bloodstream. Prolonged exposure to high levels of gadolinium may possibly trigger nephrogenic systemic fibrosis.
Nephrogenic systemic fibrosis can begin days to months after exposure to gadolinium-containing contrast, but progresses quickly. The condition is generally long term (chronic), but some patients may improve. In a few people, it can cause severe disability, even death. The disease occurs in people of all ages, but usually strikes in middle age.
Although more research is needed, possible conditions that may lead to or promote the disease when severe kidney disease and exposure to gadolinium-containing contrast are present include: