Published: 29 September 2017
Author(s): Soung Y. Kim, Martin H. Maurer, Johannes K. Richter, Johannes T. Heverhagen, Ingrid B. Boehm
Section: Letter to the Editor

Gadolinium-based contrast agents (GBCAs) are widely used in clinical magnetic resonance imaging (MRI). Since their approval for clinical use in 1988, the frequency of GBCA application has steadily expanded, and now it is estimated that more than 40 million doses of GBCAs are given worldwide each year [1]. Overall, the tolerability of GBCAs was shown to be excellent with severe serious adverse reactions in only a small proportion of about 0.03% of all patients [2]. However, over a decade ago, it became evident that patients with severe renal insufficiency (chronic kidney disease (CKD) stages 5 and 6) may acquire nephrogenic systemic fibrosis (NSF) [3].

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