Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy; Nephrology Dialysis and Transplant Unit, University of Modena and Reggio Emilia, AOU Policlinico of Modena, Modena, Italy.
Nephrology Dialysis and Transplant Unit, University of Modena and Reggio Emilia, AOU Policlinico of Modena, Modena, Italy.
Magn Reson Imaging. 2020 Jul;70:1-4. doi: 10.1016/j.mri.2020.02.012. Epub 2020 Feb 26.
Nephrogenic system fibrosis (NSF) is a rare complication detected in patients with renal insufficiency exposed to gadolinium-based contrast agents (GBCAs). The aim of our study is to evaluate the prevalence of NSF in a cohort of patients on renal replacement treatment who underwent GBCA-enhanced magnetic resonance imaging (MRI).
We retrospectively reviewed all the charts of kidney transplant (KT) recipients, patients on hemodialysis (HD) and peritoneal dialysis (PD) who received a uniform protocol for contrast material enhanced-MRI with gadoteric acid at our center from January 2004 to December 2017.
Three-hundred forty-four patients (44.1% on HD, 11.3% on PD and 44.4% KT recipients) underwent 551 gadoteric acid-enhanced MRI. The median age of the patients was 58 years (IQR, 45-70 years) and 65.1% were men. Sixty-three patients (18.3%) had skin punch biopsy after integumentary assessment performed by a dermatologist. No cases of NSF were detected after a median follow-up of 4.5 years (IQR, 1.9-8.2 years). During this period of observation, 116 (33.7%) patients died and 11 (3.1%) were lost at follow-up.
None of the patients exposed to gadoteric acid developed NSF. Our results, in line with more recent studies, suggest that the use of gadoteric acid, a macrocyclic GBCA, appears safe even in chronic kidney disease (CKD) patients receiving dialysis.
肾源性系统纤维化（NSF）是一种在肾功能不全患者中暴露于基于钆的造影剂（GBCA）后发现的罕见并发症。我们研究的目的是评估在接受 GBCA 增强磁共振成像（MRI）的接受肾脏替代治疗的患者队列中 NSF 的患病率。
我们回顾性地审查了 2004 年 1 月至 2017 年 12 月在我们中心接受均匀对比材料增强-MRI 方案的肾移植（KT）受者、血液透析（HD）和腹膜透析（PD）患者的所有图表。
344 例患者（44.1%在 HD 上，11.3%在 PD 上，44.4%在 KT 受者上）接受了 551 次钆替酸增强 MRI。患者的中位年龄为 58 岁（IQR，45-70 岁），65.1%为男性。在皮肤科医生进行皮肤穿刺活检评估后，有 63 例患者（18.3%）接受了皮肤穿刺活检。在中位随访 4.5 年（IQR，1.9-8.2 年）后，未发现 NSF 病例。在此观察期间，116 例（33.7%）患者死亡，11 例（3.1%）失访。
接触钆替酸的患者均未发生 NSF。我们的结果与最近的研究一致，表明即使在接受透析的慢性肾脏病（CKD）患者中，使用大环 GBCA 钆替酸似乎也是安全的。
