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What is Nephrogenic Systemic Sclerosis or NSF in End Stage Kidney Disease Patients?

With this disease, it helps to learn the terminology:

Nephro: mean kidney
Genic: steming from, in this case, arising from the kidney

Systemic: implies more than one organ involved, in otherwords, a whole body problems

Sclerosis: means 'hardening' or making inflexible. For example, a scar that is hardened or woody in texture, would be sclerotic.

There are disease conditions such as scleroderma ('hard skin') that can make skin and other organs inflexible. Nephrogenic Systemic Sclerosis is a newly recognized disorder primarily in patients with End Stage Renal Disease (ESRD) or on Dialysis. Patients with NSF develop thickened tough skin that limits mobility as it involves the joints. The sclerotic or hardening changes can progress to involve internal organs, which may be fatal.

Patients with ESRD often have other organ problems, necessitating imaging such as CT scans. Due to poor kidney function, ESRD patients may not eliminate the dye given during these X Ray, MRI or CT studies. One of the dyes used in imaging tests called MRI or MRA was Gadolinium.

It is now thought that Nephrogenic Systemic Sclerosis is a delayed reaction to Gadolinium given to end stage renal disease patients prior to MRI or MRA scans. ESRD patients may retain the dye in skin and other tissues and later develop a type of immune or allergic reaction that causes hardening of the skin and organs.

FDA: New warnings required on use of gadolinium-based contrast agents

FDA NEWS RELEASE September 9, 2010
Media Inquiries:
Karen Riley, 301-796-4674; karen.riley@fda.hhs.gov

Consumer Inquiries: 888-INFO-FDA

Enhanced screening recommended to detect kidney dysfunction

 

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