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Nephrogenic Systemic Fibrosis Risk for Dialysis Patients

Exposure to gadolinium significant risk factor

FRIDAY, Oct. 19 (HealthDay News) -- Exposure to contrast material containing gadolinium is a significant risk factor for nephrogenic systemic fibrosis in patients undergoing hemodialysis, researchers report in the October issue of Arthritis & Rheumatism.

Derrick J. Todd, M.D., Ph.D., of Harvard Medical School in Boston, and colleagues conducted a study of hemodialysis patients to assess the impact of gadolinium exposure on the risk of developing nephrogenic systemic fibrosis and the associated mortality risk.

Of 186 patients, 25 (13 percent) had cutaneous changes that were indicative of nephrogenic systemic fibrosis. In patients with these changes, two-year mortality was 48 percent versus 20 percent for patients without symptoms of nephrogenic systemic fibrosis. Gadopentetate dimeglumine contrast had been used in the imaging process for 54 patients, of whom 16 (30 percent) developed cutaneous changes of nephrogenic systemic fibrosis.

"Nephrogenic systemic fibrosis, a complication of renal failure that has emerged over the past decade, is prevalent. Although seemingly underrecognized, nephrogenic systemic fibrosis appears to be an emerging epidemic in patients receiving hemodialysis," the authors conclude. "To assess for nephrogenic systemic fibrosis, the routine evaluation of hemodialysis patients should include careful skin examination."

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