Kielstein J T, Schiffer M
Abteilung Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Deutschland.
Internist (Berl). 2010 Jan;51(1):39-44. doi: 10.1007/s00108-009-2408-9.
Nephrogenic systemic fibrosis (NSF) is a progressive, potentially fatal systemic multiorgan fibrosing disease related to exposure of patients with advanced renal failure to the gadolinium-based contrast agents (GBCAs) used in magnetic resonance imaging. Because of this relationship between nephrogenic systemic fibrosis and gadolinium-based contrast agents, the U.S. Food and Drug Administration currently warns against using gadolinium-based contrast agents in patients with a glomerular filtration rate less than 30 ml per minute per 1.73 m(2), or any acute kidney injury related to the hepatorenal syndrome or perioperative liver transplantation. Linear non-ionic GBCAs that are more prone to release free gadolinium are the more likely to cause NSF. The mechanism for NSF is not fully understood, yet risk factors have been described. As there is no established therapy for NSF the prevention of exposure to gadolinium is crucial in high risk patients.
肾源性系统性纤维化（NSF）是一种进行性、潜在致命的系统性多器官纤维化疾病，与晚期肾衰竭患者接触磁共振成像中使用的钆基造影剂（GBCAs）有关。由于肾源性系统性纤维化与钆基造影剂之间的这种关系，美国食品药品监督管理局目前警告，对于肾小球滤过率低于每分钟30毫升/1.73平方米或任何与肝肾综合征或围手术期肝移植相关的急性肾损伤患者，不要使用钆基造影剂。更容易释放游离钆的线性非离子型GBCAs更有可能导致NSF。NSF的发病机制尚未完全明确，但已描述了相关风险因素。由于目前尚无针对NSF的确立疗法，对于高危患者而言，预防接触钆至关重要。
