Gadolinium Retention and Toxicity-An Update

Adv Chronic Kidney Dis. 2017 May;24(3):138-146. doi: 10.1053/j.ackd.2017.03.004.


Until 2006, the main considerations regarding safety for all gadolinium-based contrast agents (GBCAs) were related to short-term adverse reactions. However, the administration of certain "high-risk" GBCAs to patients with renal failure resulted in multiple reported cases of nephrogenic systemic fibrosis. Findings have been reported regarding gadolinium deposition within the body and various reports of patients who report suffering from acute and chronic symptoms secondary to GBCA's exposure. At the present state of knowledge, it has been proved that gadolinium deposits also occur in the brain, irrespective of renal function and GBCAs stability class. To date, no definitive clinical findings are associated with gadolinium deposition in brain tissue. Gadolinium deposition disease is a newly described and probably infrequent entity. Patients presenting with gadolinium deposition disease may show signs and symptoms that somewhat follows a pattern similar but not identical, and also less severe, to those observed in nephrogenic systemic fibrosis. In this review, we will address gadolinium toxicity focusing on these 2 recently described concerns.

Keywords: Gadolinium deposition disease; Gadolinium storage condition; Gadolinium-based contrast agents; Toxicity.

Publication types

  • Review

MeSH terms

  • Brain / metabolism*
  • Cognitive Dysfunction / chemically induced
  • Contrast Media / adverse effects*
  • Contrast Media / chemistry
  • Contrast Media / metabolism*
  • Contrast Media / pharmacokinetics
  • Gadolinium / adverse effects*
  • Gadolinium / chemistry
  • Gadolinium / metabolism*
  • Gadolinium / pharmacokinetics
  • Humans
  • Magnetic Resonance Imaging
  • Pain / chemically induced
  • Renal Insufficiency, Chronic / complications
  • Skin Diseases / chemically induced


  • Contrast Media
  • Gadolinium