Systemic gadolinium toxicity in patients with renal insufficiency and renal failure: retrospective analysis of an initial experience

Mayo Clinic Proceedings
T M ArsenaultR L Ehman

Abstract

To study the possible deleterious systemic effects of gadolinium in patients with impaired renal function. We retrospectively analyzed the routine laboratory data and clinical course of patients who had undergone a gadolinium-enhanced magnetic resonance imaging (MRI) examination of the brain and spine and had evidence of impaired glomerular filtration. Between October 1988 and October 1992, 15,830 patients underwent gadolinium-enhanced MRI at our institution, 151 of whom had a serum creatinine value of more than 2 mg/dL. The clinical records of these 151 patients were thoroughly examined for the period from 3 days before to 30 days after the gadolinium-enhanced MRI examination. All data were analyzed in an attempt to detect any adverse events that could be related to free gadolinium as a result of dissociation from the chelating agent due to prolonged elimination times (that is, increased serum creatinine concentrations). In addition, we calculated the 90-day mortality rate for both the study group and a matched control population of 80 patients who had undergone MRI of the brain and spine before gadolinium was available. The overall incidence of adverse events in the study group was 3.6%. No event was severe or life threatenin...Continue Reading

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