| NSF/NFD is a very rare but very serious, and | | | | up to 30 hours or more. This allows the gadolinium to |
| sometimes fatal, condition. It has been closely | | | | undergo a chemical change and become distributed |
| associated with the use of gadolinium-based contrast | | | | throughout the organs of the body The gadolinium is |
| agents used in MRI's and MRA's, and so far has only | | | | allowed to remain in their systems long enough to get |
| occurred in people with renal insufficiency. Because | | | | into the skin and cause NSF/NFD. |
| there is no cure for NSF/NFD, and the condition is very | | | | Hemodialysis immediately after testing may eliminate |
| resistant to treatment, there is currently a very heavy | | | | some of the gadolinium. Typically, two or three, or |
| emphasis on prevention. | | | | more, sessions are needed to remove the toxin, but by |
| Patients with moderate to severe renal insufficiency | | | | doing so quickly after testing, gadolinium may not have |
| are at the highest risk for developing NSF/NFD. | | | | the chance to spread throughout the body. |
| Anyone with renal insufficiency should avoid gadolinium | | | | Hemodialysis may not be safe for everyone. Many |
| exposure if possible, but for some people, tests using | | | | doctors believe that patients who are not already in |
| the contrast agent are necessary. In any event, | | | | dialysis should not use the procedure just for |
| patients with any level of renal insufficiency should be | | | | gadolinium removal, because initiating dialysis can mean |
| informed of the risks involved, and have the | | | | a permanent dependence on the procedure. Each |
| opportunity to decide for themselves, while taking into | | | | person must be individually evaluated, and the benefits |
| consideration the advice of their doctors, whether the | | | | and risks of dialysis must be carefully weighed. |
| benefits outweigh the risks. | | | | Different gadolinium contrast agents |
| Dose | | | | All gadolinium-based contrast agents are considered to |
| The experts in NSF strongly recommend that when | | | | carry a possible risk of causing NSF/NFD, but some |
| tests using contrast agents are absolutely necessary | | | | are more dangerous than others. So far, of the five |
| for people with renal insufficiency, the lowest effective | | | | gadolinium-based contrast agents approved by the |
| dose should be used, especially in those with | | | | FDA, only three have been linked to NSF/NFD. Most |
| advanced kidney disease. | | | | cases have occurred after the use of Omniscan, and |
| Dialysis | | | | some after using Magnevist and OptiMARK. |
| Gadolinium is primarily removed from the body by the | | | | Some experts worry that low-risk patients will be |
| kidneys. Therefore, people whose kidneys are not | | | | overly cautious and go without the tests that they |
| functioning properly do not eliminate the gadolinium as | | | | need. Each case has to be considered individually |
| quickly and effectively as patients with normal | | | | based on risk factors and the level of need for tests |
| functioning kidneys. Patients with normal functioning | | | | using the contrast agent. |
| kidneys eliminate one-half of the injected gadolinium in | | | | If you believe you have developed NSF, we strongly |
| 90 minutes while those with moderate to severe renal | | | | advise you to contact your physician for an |
| insufficiency, the half life of gadolinium is extended to | | | | examination which may involve a skin biopsy. |