Nephrotoxicity gadolinium

The use of gadolinium-based contrast media for radiographic examinations is not recommended to avoid nephrotoxicity in patients with renal impairment, since they are more nephrotoxic than iodinated contrast media in equivalent X-ray attenuating doses... 

This case underlines the fact that there is still misunderstanding about the nephrotoxic potential of gadolinium-based contrast agents. They should not replace iodinated contrast agents in patients with renal insufficiency. The recommended doses of up to 0.3 mmol/kg will not give satisfactory radiographic diagnostic information in most cases. 

Gadolinium Can be used in urgent situations in patients with severe iodine allergy Vasciflar enhancement not as dense risk of increased nephrotoxicity with large gadolinium doses... 

The renal adverse effects of gadolinium-based contrast agents have been reviewed in patients with chronic renal insufficiency [30A]. The authors suggested that gadolinium chelates are safe and not nephrotoxic when used intravenously for MRI or MRA in patients with normal renal function, or in patients with pre-existing renal insufficiency when they are used in doses similar to those recommended for MRI. They also suggested that renal function is likely to deteriorate in most cases after intra-arterial administration of gadolinium-based media at doses over 0.2 mmol/kg... 

Gadolinium agents are considered to have no nephrotoxicity at approved dosages for MR imaging. Therefore, MR with gadolinium has been used instead of contrast-enhanced CT in ttiose at risk for developing worsening renal failure if exposed to iodinated contrast media. 

Prince MR, Arnoldus C, Erisoli JK (1996) Nephrotoxicity of high-dose gadolinium compared with iodinated contrast. J Magn Reson Imaging 6 162-166... 

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