Gadolinium-based contrast media and the development of nephrogenic systemic fibrosis in patients with renal insufficiency

Gadolinium-based contrast media are important tools in diagnostic and interventional radiology that are particularly useful in patients with renal insufficiency. Recent reports in which exposure to gadolinium compounds has been linked to the development of nephrogenic systemic fibrosis in this patient population, however, are quite concerning. It is of great importance that radiologists be aware of this serious disease and exercise caution when considering the use of gadolinium-based contrast media in patients with moderate (glomerular filtration rate, < 60 mL/min/1.73 m(2)) to severe (glomerular filtration rate, < 15 mL/min/1.73 m(2)) renal disease.