Impact on hospital policy: Yale experience.

To limit patients who may be at risk for nephrogenic systemic fibrosis from exposure to gadolinium-based magnetic resonance contrast agents, new policies and procedures have been implemented at Yale-New Haven Hospital. These changes include screening patients for low estimated glomerular filtration rates and risk factors for chronic kidney disease, giving increased attention to the types and doses of contrast agent administered, agreement on alternative imaging algorithms, and education at all levels of the medical community. The rationale for these changes is discussed.