MRI contrast kidney problem warnings added for risk of NSF

Austin Kirk

By Austin Kirk
Posted September 29, 2007

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Yesterday the makers of MRI contrast agents containing gadolinium announced the language of a “black box” warning they have added to the labels of their products.  They also released a letter which was sent to healthcare providers notifying them of the risk of nephrogenic systemic fibrosis among those with kidney problems.  This finalizes the warnings which the FDA requested in May 2007.

>>INFORMATION: MRI Contrast Kidney Problems

The warning indicates that when gadolinium-based MRI contrast agents are given to those with kidney problems or liver conditions, it may lead to a serious and potentially fatal condition known as nephrogenic systemic fibrosis (NSF)

There are five different types of contrast agents used during MRIs and MRAs which contain gadolinium:

NSF is a serious and painful medical condition which leads to excessive formation of connective tissue in the skin and internal organs.  It often appears as a hardening and thickening of the skin, primarily on the arms, legs or trunk.  The fibrosis causes severe limitations of the movement of the joints and in some cases it can lead to death.

The gadolinium boxed warning states:

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS

Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with:

  • Acute or chronic severe renal insufficiency (glomerular filtration rate <30mL/min/1.73m2), or
  • Acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period

In these patients, avoid use of gadolinium-based contrast agents unless the diagnostic information is essential and not available with non-contrast enhanced magnetic resonance imaging (MRI).  NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs.  Screen all patients for renal dysfunction by obtaining a history and/o laboratory tests.  When administering a gadolinium-based contrast agent, do not exceed the recommended dose and allow a sufficient period of time for elimination of the agent from the body prior to any readministration.

The FDA has received reports of over 250 individuals who developed NSF after receiving the MRI contrast.  However, most expect that number to drastically increase as more physicians become aware of the symptoms and recognize the condition in their patients.  It is generally believed that the number of FDA reported adverse effects associated with medical products is between 1% and 10% of the true number of cases.

According to the FDA, there have been no reports of NSF among those with normal kidney function or those with only mild kidney insufficiencies.  The letter from the manufacturers estimates that the risk of developing NSF among those with severe kidney problems is about 4%. 

GADOLINIUM LAWSUITS

The gadolinium lawyers at Saiontz & Kirk, P.A. represent individuals diagnosed with nephrogenic systemic fibrosis, previously known as nephrogenic fibrosing dermopathy.  The gadolinium contrast agents are the only known cause for this condition, and the manufacturers previously failed to provide adequate warnings about this potential problems for those with kidney insufficiencies.  If you, a friend or family member suspect that you may qualify for a gadolinium lawsuit, request a free claim evaluation.

4 Comments • Add Your Comments

  • cabell mitchell says:

    I have had kidney problems most of my life, back in sept this year , I had a mri with contrast, twice in a short period of time , one with my kidney doctor
    and the pther with my neurologist , short time afterwards I notice changes in my skin , beacame hard leathery , itching , and joints hurting now it looks aweful , went had a dermotologist take a
    biopsy of my skin and awaiting results , my skin was ok till this happened can you help me

    Posted on December 8, 2007 at 2:54 am

  • kim shirah davis says:

    I have had over 30 procedures done in the last nine years. I have constant pain in my rib and flank area. I know that I have had multiple x-rays, but am not sure what they gave me when they did the ones with the dyes. I do not have any of the signs of thickening of the skin or things like that. I was wondering if there is more you can tell me about the symptoms.
    I have struvite stones and have been cut open to get access to my kidney. If there is anything that you can tell me about the onset of the symptoms or what to look for, it would help me greatly.
    Thanks,
    Kim Shirah Davis

    Posted on January 15, 2008 at 6:07 pm

  • Christine says:

    On april 11th 2007 I has sergury for a renal artery aneurysm. They performed coil embolization and stenting across the branches of the left renal artery. I had both MRI’S AND CT SCANS both before and after my surgery. Just a few days after the surgury I notices a dark patch on my back (left side) and to this day is still remains there. I have also had alot of illness in the last year and a miscarraige.

    Posted on April 10, 2008 at 11:07 am

  • BILLY says:

    I HAVE HAD SEVERAL MRI’S AND CT SCANS OVER THE PAST 3-4 YEARS. I HAVE DEVELOPED A RASH OVER MY BODY THAT IS VERY RED, IRRITATED AND ITCHES. I HAVE BEEN TO A DERMATOLOGIST 3 TIMES AND THEY TELL ME THAT IS FROM THE MEDICINE HUMIRA THAT I HAVE BEEN TAKING FOR ANKYLOSIS SPONDILYTIS. I ALSO HAVE A HISTORY OF KIDNEY STONES. FOR THE PAST SEVERAL MONTHS WHEN THEY CHECK MY URINE, I AM KEEPING A FAIR AMOUNT OF BLOOD IN MY URINE, THEY SENT ME FOR A CT SCAN A SAY THAT I HAVE 3 KIDNEY STONES AND THAT IS WHAT IS CAUSING THE BLOOD. I HAVE CHRONIC JOINT PAIN AND STIFFNESS. AFTER READING THE INFORMATION ABOUT THE EFFECTS OF THE GADOLINIUM CONTRAST I AM AFRAID THAT I MAYBE HAVING SOME PROBLEMS FROM IT.

    Posted on May 7, 2008 at 9:10 am

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