Nephrogenic systemic fibrosis (NSF) is an uncommon disorder of the organs and skin that predominantly affects people with severe kidney disease. The disease develops when patients have negative reactions to the contrast dyes used in imaging scans such as magnetic resonance imaging or MRIs. These tests require injections that enable the doctor to evaluate the scans, but repeated injections of the dye agent gadolinium can cause thickening of the skin and underlying tissues (fibrosis) with the formation of firm nodules and hardening of skeletal muscles.
Gadolinium is a metallic element used in gadolinium-based contrast agents (GBCA). The rare earth metal can be converted to an injectable solution given intravenously to a patient prior to an imaging scan. According to the FDA, GBCAs clarify, contrast, and provide detailed images of MRI kidney scans. People with severe renal insufficiency cannot eliminate gadolinium from the body. One study found that after gadolinium enters the bloodstream, the substance goes to the brain and remains there, instead of being removed through urination. Currently, the health implications of gadolinium remaining in the brain are unclear.
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