Nephrogenic Systemic Fibrosis Review of 370 Biopsy-Confirmed Cases
Nephrogenic Systemic Fibrosis Review of 370 Biopsy-Confirmed Cases
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DOI：
10.1016/j.jcmg.2011.08.013
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发表时间：
2011-11-01
影响因子：
14
通讯作者：
Prince, Martin R.
中科院分区：
文献类型：
--
作者：
Zou, Zhitong;Zhang, Hong Lei;Prince, Martin R.
钆基造影剂（gbca）与肾源性系统性纤维化（NSF）之间的关联的发现，减少了透析患者和有NSF风险的严重肾衰竭患者使用gbca增强磁共振成像，并几乎消除了新的NSF病例。但将肾功能衰竭患者转移到其他成像方法可能会使患者面临其他风险（例如电离辐射或碘化造影剂）。本文回顾了98篇报道的370例NSF病例，分析NSF的危险因素。通过将GBCA剂量限制在最大0.1 mmol/kg，在给予GBCA后迅速透析患者，将急性肾衰竭患者的GBCA延迟至肾功能恢复或透析开始后，避免非离子型线性GBCA，特别是在有促炎条件的肾衰竭患者中，消除多种危险因素，可以大大降低NSF的风险。[J]中华医学会心脏科杂志，2011;4 (4):1158 - 1158
Discovery of an association between gadolinium-based contrast agents (GBCAs) and nephrogenic systemic fibrosis (NSF) has led to less use of GBCA-enhanced magnetic resonance imaging in dialysis patients and patients with severe renal failure at risk of NSF, and the virtual elimination of new cases of NSF. But shifting patients with renal failure to alternative imaging methods may subject patients to other risks (e.g., ionizing radiation or iodinated contrast). This review paper examines 370 NSF cases reported in 98 articles to analyze NSF risk factors. Eliminating multiple risk factors by limiting GBCA dose to a maximum of 0.1 mmol/kg, dialyzing patients undergoing dialysis quickly following GBCA administration, delaying GBCA in acute renal failure until after renal function returns or dialysis is initiated, and avoiding nonionic linear GBCA in patients with renal failure especially when there are proinflammatory conditions may substantially reduce the risk of NSF. (J Am Coll Cardiol Img 2011;4:1206-16) (C) 2011 by the American College of Cardiology Foundation