Nephrogenic Systemic Fibrosis

About

Nephrogenic systemic fibrosis may resemble skin diseases such as scleroderma and scleromyxedema, with thickening and darkening developing on large areas of the skin.

Nephrogenic systemic fibrosis can start and progress quite quickly and then stop within a few months. But in that time it can cause severe disability, even death. The disease occurs in people of all ages, but usually strikes in middle age.

A study by the Centers for Disease Control and Prevention (CDC) identified exposure to gadolinium-containing contrast agents during MRI studies as a significant risk factor for development of this disease among patients with moderate to end-stage kidney disease. The CDC recommends against using this contrast agent in people with advanced kidney failure.

A number of studies have pointed to the following groups as having the highest risk of this disease; people who:

• Have moderate to severe kidney disease
• Have had a kidney transplant
• Are receiving hemodialysis
• Have hepatorenal syndrome

This increased risk is thought to be related to the reduced ability of these people's kidneys to cleanse the contrast agent from the bloodstream.

Mayo Clinic examined its patient records to identify people who had been exposed to gadolinium-based contrast agents over the last 15 years, in an effort to determine the risk of later developing nephrogenic systemic fibrosis. The study found about a 1 percent risk of developing the disease among people who undergo hemodialysis or had a kidney transplant.