High prevalence of nephrogenic systemic fibrosis in chronic renal failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent
High prevalence of nephrogenic systemic fibrosis in chronic renal failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent
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DOI：
10.1097/rli.0b013e31815a3407
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发表时间：
2008-02-01
影响因子：
6.7
通讯作者：
Marckmann, Peter
中科院分区：
文献类型：
--
作者：
Rydahl, Casper;Thomsen, Henrik S.;Marckmann, Peter
目的：肾源性系统性纤维化（NSF）是影响肾功能衰竭患者的严重疾病。它可能由某些含钆（Gd）造影剂引起，包括钆双胺。本研究旨在评估慢性肾脏病（CKD）患者接受钆双胺暴露后NSF的患病率。材料和方法：回顾性队列研究，纳入2004年1月1日至2006年3月21日期间接受钆双胺增强磁共振成像的190例不同肾功能类别的连续肾病患者。（18/190; 10%，95% CI：6%-15%）在平均29个月（范围16-43个月）的随访期内被诊断为NSF。所有18例病例在接触钆双胺时均患有5期CKD（即估计肾小球滤过率低于15 mL/min/1.73 m2或正在接受透析治疗）。暴露时5期CKD患者（n = 102）的NSF患病率为18%（95% CI：11%-27%）。88例钆双胺暴露患者中无一例出现轻度肾功能不全（患病率0%，95%CI：0%-4%）。结论：在钆双胺暴露的5期CKD患者中，NSF的风险高得不可接受。
Objective: Nephrogenic systemic fibrosis (NSF) is a serious disease affecting renal failure patients. It may be caused by some gadolinium (Gd)-containing contrast agents, including gadodiamide. The study aimed at estimating the prevalence of NSF after gadodiamide exposure for patients with chronic kidney disease (CKD).Materials and Methods: Retrospective cohort study of 190 consecutive nephrological patients in different categories of kidney function referred for gadodiamide-enhanced magnetic resonance imaging in the period January 1, 2004 to March 21, 2006.Results: Eighteen patients (18/190; 10%, 95% CI: 6%-15%) were diagnosed with NSF within a mean follow-up period of 29 months (range 16-43 months). All 18 cases had stage 5 CKD (ie, estimated glomerular filtration rate less than 15 mL/min/1.73 m(2) or in dialysis therapy) at the time of their gadodiamide exposure. The prevalence of NSF among patients with stage 5 CKD at exposure (n = 102) was 18% (95% CI: 11%-27%). No cases were seen among 88 gadodiamide-exposed patients who had milder degrees of renal insufficiency (prevalence 0%, 95% CI: 0%-4%).Conclusions: The risk of NSF is unacceptably high among stage 5 CKD patients exposed to gadodiamide.