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Nephrogenic systemic fibrosis (NSF) — a severe and often fatal condition caused by collagen deposition in soft tissues and organs — occurs (rarely) in patients after receiving gadolinium-based contrast agents (GBCAs) for magnetic resonance imaging. Newer gadolinium agents might pose less risk than older ones (NEJM JW Gen Med Feb 15 2018 and Radiology 2018; 286:113).
In this systematic review of 20 observational studies, researchers found no cases of NSF among >83,000 patients who had been exposed to newer GBCAs, but fewer than 20% of patients had any chronic kidney disease (<3% with stage 3–5 disease and 1% who were receiving dialysis). Analysis of 12 additional studies that allowed a comparison of NSF risk between older GBCAs (≈110,000 pati…