Nephrogenic systemic fibrosis: an epidemic of gadolinium toxicity

Curr Rheumatol Rep. 2008 Jul;10(3):195-204. doi: 10.1007/s11926-008-0033-6.


Nephrogenic systemic fibrosis is a devastating systemic fibrosing disorder that afflicts patients with renal dysfunction. Growing evidence supports the hypothesis that gadolinium-containing contrast agents (GCCAs) trigger the development of nephrogenic systemic fibrosis. Hence, this condition is most appropriately called gadolinium---associated systemic fibrosis (GASF). In this report, we review the history of GASF, its association with prior GCCA exposure, its clinicopathologic features, the relevant pharmacology of GCCAs, the likely role of GCCAs in its pathogenesis, and potential treatments.

Publication types

  • Review

MeSH terms

  • Contrast Media / adverse effects*
  • Fibrosis / chemically induced
  • Fibrosis / pathology
  • Gadolinium / adverse effects*
  • Humans
  • Kidney / drug effects
  • Kidney Failure, Chronic / chemically induced*
  • Kidney Failure, Chronic / pathology
  • Skin / drug effects
  • Skin Diseases / chemically induced*
  • Skin Diseases / pathology


  • Contrast Media
  • Gadolinium