Nephrogenic Systemic Fibrosis: A Review of History, Pathophysiology, and Current Guidelines

  • Julian M. HazeltonEmail author
  • Michael K. Chiu
  • Hani H. Abujudeh
Quality and Safety (H Abujudeh, Section Editor)
Part of the following topical collections:
  1. Quality and Safety


Purpose of Review

Nephrogenic systemic fibrosis (NSF) is a rare systemic disease with a high mortality. The purpose of this review is to provide clinicians with guidance regarding safe administration of GBCAs to patients with renal disease.


Development of NSF has been linked to the administration of gadolinium-based contrast agents (GBCAs) in patients with renal disease. Due to the wide variety of available GBCAs and recommendations regarding safe administration of these agents, it can be difficult for clinicians to choose the best GBCA for this patient population.

Recent Findings

Although the current ACR guidelines have virtually eliminated the risk of NSF, future research may lead to the development of alternative contrast agents for patients at risk of NSF who require contrast-enhanced MRIs.


Gadolinium Nephrogenic systemic fibrosis MRI contrast guidelines Gadolinium safety End-stage renal disease 



The authors would like to thank Dr. Harlan Harvey for reviewing their manuscript.

Compliance with Ethical Guidelines

Conflict of interest

Julian M. Hazelton and Michael K. Chiu each declare no potential conflicts of interest. Hani H. Abujudeh is a section editor for Current Radiology Reports.

Human and Animal Rights

This article does not contain any studies with human or animal subjects performed by any of the authors.


Recently published papers of particular interest have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Julian M. Hazelton
    • 1
    Email author
  • Michael K. Chiu
    • 1
  • Hani H. Abujudeh
    • 1
  1. 1.Department of RadiologyDetroit Medical CenterDetroitUSA

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