| Title | Large sample of nephrogenic systemic fibrosis cases from a single institution. | | Author(s) | Lee CU, Wood CM, Hesley GK, Leung N, Bridges MD, Lund JT, Lee PU, Pittelkow MR | | Institution | Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. lee.christine@mayo.edu | | Source | Arch Dermatol 2009 Oct; 145(10):1095-102. | | MeSH | Academic Medical Centers
Adult
Age Distribution
Aged
Cohort Studies
Female
Gadolinium DTPA
Humans
Incidence
Kidney Failure, Acute
Kidney Transplantation
Male
Middle Aged
Minnesota
Nephrogenic Fibrosing Dermopathy
Prognosis
Renal Dialysis
Retrospective Studies
Risk Assessment
Sampling Studies
Severity of Illness Index
Sex Distribution
| | Abstract | OBJECTIVES: To estimate and stratify the risk of development of nephrogenic systemic fibrosis (NSF) in well-defined at-risk subpopulations from a large single institution, and to perform a single-institution case series study of patients with biopsy-proven NSF.
DESIGN: Retrospective cohort of patients exposed to gadolinium-based contrast agents (GBCAs) at a single institution during an 8-year period (January 1, 1999, to December 31, 2006), and a case series study of patients with biopsy-proven NSF.
SETTING: A primary, secondary, and tertiary health care center that treated more than 2.2 million outpatients and had 135 000 hospital admissions in 2007. Patients A total of 94 917 patients exposed to GBCAs; patients at risk for NSF (3779 patients on hemodialysis, 1694 patients with renal transplants, and 717 patients with liver transplants, a well-defined subgroup that includes patients at risk for reduced renal function); and 61 patients with a clinical diagnosis of NSF.
MAIN OUTCOME MEASURE: Risk estimate for NSF.
RESULTS: The risk of development of NSF is 1.0% for patients who undergo hemodialysis (8 of 827), 0.8% for patients with renal transplantation (4 of 527), and 0% for patients with liver transplantation at our institution (0 of 327).
CONCLUSIONS: Despite the limitations, this study, which reviewed a large number of patients who underwent intravascular GBCA injections, demonstrates a 77-fold higher risk of NSF among patients who undergo hemodialysis and a 69-fold higher risk in patients with renal transplantation. This increased risk is thought to be associated with poor clearance of most GBCAs. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, Non-U.S. Gov't
| | PubMed ID | 19841395 |
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