Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Filters applied. Clear all
Review
. 2009 Mar;24(3):856-63.
doi: 10.1093/ndt/gfn593. Epub 2008 Oct 24.

Gadolinium-based Contrast Agents and Nephrogenic Systemic Fibrosis: A Systematic Review and Meta-Analysis

Affiliations
Review

Gadolinium-based Contrast Agents and Nephrogenic Systemic Fibrosis: A Systematic Review and Meta-Analysis

Rajender Agarwal et al. Nephrol Dial Transplant. .

Abstract

Background: In the past decade, more than 200 cases of nephrogenic systemic fibrosis (NSF) have been identified, primarily among patients with advanced kidney disease. Multiple studies have suggested an association between gadolinium-based contrast agents (GBCAs) and NSF. We performed a systematic review and meta-analysis to examine this potential association.

Methods: A systematic review of studies examining the association between any GBCA and NSF was performed. A search for controlled studies was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. If controlled data for a GBCA was not available, we searched for case reports and series. Relevant data were extracted and meta-analyses were performed.

Results: Seven of 144 identified studies met inclusion criteria; gadodiamide was the sole or predominant GBCA in four of these; one study exclusively examined gadopentetate. Other GBCAs were not specifically examined in controlled or uncontrolled studies. Meta-analysis of controlled trials demonstrated a significant association between GBCA exposure and NSF [odds ratio (OR) 26.7; 95% confidence interval (CI) 10.3-69.4] and gadodiamide and NSF (OR 20.0; 95% CI 3.7-107.8). Examination of the evidence using established criteria suggested that this association was causal.

Conclusions: The current state of evidence suggests an association and potentially causal link between the use of GBCAs and the development of NSF among patients with advanced kidney disease. Additional study is warranted to clarify the potential association of GBCAs other than gadodiamide with NSF.

Comment in

Similar articles

See all similar articles

Cited by 38 articles

See all "Cited by" articles

MeSH terms

Feedback