Medizinische Monatsschrift für Pharmazeuten
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The approval of gadofosveset trisodium as the first imaging agent for magnetic resonance angiography (MRA) by the US Food and Drug administration (FDA) in December 2008 served as a motive to review a rare serious adverse reaction possibly related to the use of gadolinium based contrast agents. Nephrogenic systemic fibrosis (NSF) is a disabling and potentially fatal disease characterized by thickening and hardening of the skin, especially of the extremities. It is restricted to patients with renal insufficiency (estimated glomerular filtration rate [eGFR] < 30ml/min/ 1,73 m2). ⋯ Since there is no effective therapy for NSF, the top priority is to avoid exposure to gadolinium based contrast agents in patients at increased risk. In case of renal insufficiency (eGFR < 30 ml/min/1,73 m2) they should only be given if clearly necessary. After a thorough risk-benefit-assessment, the lowest possible dose should be used.