Contrast agent guidelines help prevent disorder in kidney patients
A simple blood test may help prevent a serious complication associated with a contrast agent commonly used in MRI exams, according to a study published in the July issue of Radiology.
Within the past five years, use of gadolinium-based contrast agents (GBCA) has been linked to the development of nephrogenic systemic fibrosis (NSF), a rare disorder mainly affecting patients with severe kidney disease. But since 2008, restrictive GBCA administration guidelines implemented by Massachusetts General Hospital have proven effective in preventing NSF.
Massachusetts General Hospital began implementing restrictive GBCA guidelines in May 2007. The guidelines require that a blood test be done on patients over age 60 or at risk for kidney disease. The guidelines stipulate a maximum GBCA dose of 20mL for patients with a low eGFR (below 60 mL/ min/m2). GBCA should not be administered at all to patients currently undergoing dialysis treatment or with a very low eGFR (below 30 mL/min/ m2).
For the study, Dr. Abujudeh and colleagues reviewed the hospital's medical records during the pre-guideline and transition period (January 2002 through December 2007) and the post-adoption period (January 2008 to March 2010).
Prior to adoption of the guidelines and during the transition period, 113,120 contrast-enhanced MRI exams were performed, and 34 cases of NSF were subsequently identified. During the post-guideline period, 52,954 contrast-enhanced MRIs were performed with no new cases of NSF identified.
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