CKD Patients: Avoid Contrast Dyes! here's why

[FelineFandom146]

All dyes are bad for the kidneys, but there is one that is SUPER BAD! It is called Gadolinium. One of the few useful things my Nephrologist told me about. Avoid at ALL costs. Radilogists like to use it because if makes the images easier to read, but Nephrologists don't and you can ready why. Stay safe. If you doubt anything, get up and out!

Here's the link: mayoclinic.org/diseases-con...

Summary: Gadolinium related NSF

Gadolinium-Associated Nephrogenic Systemic Fibrosis (NSF) is a rare and potentially life-threatening condition caused by exposure to gadolinium-based contrast agents (GBCAs) used in magnetic resonance imaging (MRI) in patients with impaired kidney function.

Clinical Recommendation: The U.S. Food and Drug Administration (FDA) currently recommends against using GBCAs in patients with a glomerular filtration rate (GFR) less than 30 mL per minute per 1.73 m2, or any acute renal insufficiency related to the hepatorenal syndrome or perioperative liver transplantation.

Symptoms: The symptoms of NSF may develop slowly over a few weeks to a few months after exposure to GBCAs. The severity and progression of the disorder can vary from one person to another. The disorder can have a rapid, progressive course and can cause debilitating symptoms, including:

• Thickening and hardening of the skin and subcutaneous tissues

• Skin induration and stiffness

• Joint contractures

• Muscle weakness

• Pain

• Pruritus

• Edema

Causes: NSF is caused by the exposure to GBCAs in patients with impaired kidney function. The exact mechanism of NSF is not fully understood, but it is thought to be related to the deposition of gadolinium in the skin and other tissues, leading to inflammation and fibrosis.

Risk Factors: The risk of NSF is higher in patients with:

• Impaired kidney function (GFR < 30 mL per minute per 1.73 m2)

• Acute renal insufficiency related to the hepatorenal syndrome or perioperative liver transplantation

• Recent surgery, endovascular injury, or sepsis

• History of nephrogenic systemic fibrosis

Treatment: There is no specific treatment for NSF, and management is largely supportive. Treatment options may include:

• Pain management

• Physical therapy to maintain joint mobility

• Skin care to prevent further skin thickening

• Consideration of alternative imaging modalities, such as ultrasound or computed tomography (CT) scans, for patients at high risk of NSF

Prevention: Prevention of NSF is key, and this can be achieved by:

• Using alternative imaging modalities, such as ultrasound or CT scans, for patients at high risk of NSF

• Avoiding GBCAs in patients with impaired kidney function

• Monitoring patients with impaired kidney function closely for signs of NSF

• Educating patients and healthcare providers about the risks of NSF associated with GBCAs

Conclusion: Gadolinium-Associated Nephrogenic Systemic Fibrosis is a rare and potentially life-threatening condition caused by exposure to GBCAs in patients with impaired kidney function. Prevention and early recognition are crucial in managing this condition. Healthcare providers should be aware of the risks and take steps to minimize exposure to GBCAs in patients at high risk of NSF.

[Snoopy53]

As always, since being on this site, I have learned so much. Thanks for the info!

[Merny5]

Thank you for sharing this information.

[Marvin8]

Honestly, did you not even read the article in your link? To summarize; First Generation gadolinium contrast dyes....BAD. Second Generation gadolinium contrast dyes....OK.

What am I missing?

[Dana66CKD in reply to Marvin8]

I just had MRI w/contrast last Sept. 2024. Gadolinium use okay for kidney function above 60 and request extra IV fluid flush and drink lots of water before and after infusion.

[Marvin8 in reply to Dana66CKD]

Indeed, but most folks on this site have function below 60.

[FelineFandom146]

The article I posted is for those with the GFR mentioned. Others may avoid it, at your risk. No need to get sarcatic if it doesn't apply to you. But for those this article does apply to should be made aware. That is the fact. And yes, I read it. Thank you. Furthermore, my Nephrologist personally made me aware of this bad result of using Gadolinium. May I suggest that if something posted here doesn't apply to you, move on or ignore it. Just because it doesn't apply to you doesn't mean it doesn't appy to someone else. Say thank you and move on. Good for you if your GFR is above 60. Not everyone is so fortunate. I know I'm not. For those with GFR 30 or less, take heed when doing images. Just because your radiologist wants to use it doesn't make it safe. Stay safe.

[FelineFandom146]

By the way, I'm scheduled to do a CT Abdomen with Pelvis with no use of any kind of contrast due to my low GFR. In fact, without me even asking I was told not to worry but they wouldn't be using Gadolinium. So glad to hear it.