| Incidence of nephrogenic systemic fibrosis after adoption of restrictive gadolinium-based contrast agent guidelines. | |
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MedLine Citation:
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PMID: 21586680 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in a large academic medical center after the adoption of restrictive gadolinium-based contrast agent (GBCA) administration guidelines. MATERIALS AND METHODS: For this retrospective HIPAA-compliant study, institutional review board approval was obtained and the requirement for informed consent was waived. Restrictive GBCA guidelines were adopted in May 2007. The guidelines (a) require a recent serum creatinine level measurement in any patient who is aged 60 years or older and/or at risk for renal disease, (b) limit the maximal weight-based GBCA dose administered to any patient with an estimated glomerular filtration rate (eGFR) lower than 60 mL/min/m(2) to 20 mL, and (c) prohibit the administration of any GBCA in patients who have an eGFR lower than 30 mL/min/m(2) and/or are undergoing chronic dialysis treatment (except in emergency situations). The electronic medical records were searched for all contrast material-enhanced magnetic resonance (MR) imaging examinations performed during the post-guidelines adoption period between January 2008 and March 2010 and the pre-guidelines adoption and transitional period between January 2002 and December 2007. Separate pathology records were searched for biopsy-confirmed cases of NSF during the same study periods. The incidences of NSF during the pre-guidelines adoption and transitional period and post-guidelines adoption period were compared by using the paired Z test. RESULTS: A total of 52,954 contrast-enhanced MR examinations were performed during the post-guidelines adoption period. Of these 52,954 examinations, 46,464 (88%) were performed in adult patients with an eGFR of 60 mL/min/m(2) or higher or presumed normal renal function and 6454 (12%) were performed in patients with an eGFR of 30-59 mL/min/m(2). Thirty-six patients with an eGFR lower than 30 mL/min/m(2) underwent contrast-enhanced MR imaging for emergent indications. Review of the pathology records for January 2008 to September 2010 revealed no new cases of NSF resulting from GBCA exposure. CONCLUSION: After restrictive guidelines regarding GBCA administration were instituted, no new cases of NSF were identified among 52,954 contrast-enhanced MR examinations, including those performed in patients with an eGFR lower than 60 mL/min/m(2). |
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Authors:
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Yingbing Wang; Tarik K Alkasab; Ozden Narin; Rosalynn M Nazarian; Rathachai Kaewlai; Jonathan Kay; Hani H Abujudeh |
Publication Detail:
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Type: Journal Article Date: 2011-05-17 |
Journal Detail:
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Title: Radiology Volume: 260 ISSN: 1527-1315 ISO Abbreviation: Radiology Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-23 Completed Date: 2011-09-02 Revised Date: 2011-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: United States |
Other Details:
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Languages: eng Pagination: 105-11 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, Massachusetts General Hospital, 55 Fruit St, FND 213B, Boston, MA 02114, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Contrast Media Drug Toxicity / epidemiology* Female Gadolinium / diagnostic use* Guideline Adherence / statistics & numerical data* Humans Incidence Magnetic Resonance Imaging / standards*, utilization* Male Massachusetts / epidemiology Middle Aged Nephrogenic Fibrosing Dermopathy / diagnosis*, epidemiology* Practice Guidelines as Topic Risk Assessment Risk Factors Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 7440-54-2/Gadolinium |
| Comments/Corrections | |
Comment In:
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Radiologe. 2011 Oct;51(10):831-2
[PMID:
21947240
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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