Patient information: Nephrogenic Fibrosing Dermopathy

Are MRIs safe for patients with kidney disease?

Sometimes. In 2000 a new skin disease was discovered that caused patients to develop thick skin around their joints, especially the knees. The thickened skin prevented people from bending their legs so they can’t walk. The disease was initially only found in patients on dialysis.The condition was named nephrogenic fibrosing dermopathy or NFD for short.

For a long time doctor’s had no idea what caused NFD. Then in 2006 some doctors in Europe noticed that only patients who received gadolinium during an MRI developed NFD. Other physicians verified this association and now it is generally accepted, though not proven, that gadolinium is at least part of the cause of NFD.

Gadolinium is used as contrast for patients receiving an MRI when doctors want a better view of the blood vessels. It is always used in a related imaging technique called an MRA. The FDA has identified people at risk of developing NFD. The list includes people with:
1. Acute renal failure
2. CKD stages 4 or 5
3. Cirrhosis induced kidney disease (called hepatorenal sndrome)
4. End-stage renal disease on dialysis

There is no proven strategy to prevent NFD except to avoid exposure to this agent. New contrast agents are being developed that do not have gadolinium. If your medical condition absolutely requires a gadolinium MRi then your doctor may schedule special dialysis sessions to remove the toxin right after MRI.

If you are on dialysis or have any of the other risk factors you should make sure your doctor knows about NFD and you should coordinate the MRI with your nephrologist.

There is no risk of NFD if you do not receive contrast with your MRI.