Can nephrogenic systemic fibrosis be prevented?
For patients with normal kidney function, there does not appear to be any risk. Patients with kidney disease whose eGFR is below 30 ml/min/1.73 m2 are at increased risk. Only one patient has been reported to develop NSF with kidney function better than this. Patients on dialysis who require gadolinium, studies have shown that performing dialysis immediately after gadolinium-based MRI can help reduce the chances of developing nephrogenic systemic fibrosis.
The U.S. Food and Drug Administration recommends against using gadolinium-based contrast agents in patients with certain kidney problems unless there are no other options. Other imaging methods should be used on these patients if possible.
The risk for gadolinium-related damaged is less if we use the lowest dose necessary, avoid repeat doses, and only use the safer macrocytic types of gadolinium.