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Painful condition affecting kidney failure patients increases risk of death
Date:9/27/2007

A painful and debilitating condition that affects patients with kidney failure may be more common than previously believed and appears to be strongly associated with prior exposure to certain contrast agents used in imaging studies. In addition, individuals with this syndrome called nephrogenic systemic fibrosis (NSF) appear to have a significantly increased risk of dying. The findings from Massachusetts General Hospital (MGH) investigators appear in the October issue of the journal Arthritis & Rheumatism.

Our analysis found that hemodialysis patients who had undergone imaging studies using a gadolinium-containing contrast agent have more than 10 times the risk of developing NSF as do patients with no prior exposure to gadolinium, says Jonathan Kay, MD, director of the Rheumatology Clinical Research Unit at MGH, the reports senior author. Among those with NSF, the risk of dying within two years was three to five times greater than for patients without the condition from the same dialysis centers.

The primary symptoms of NSF are rapid and progressive thickening, hardening and darkening of the skin, primarily on the arms and legs. Originally believed to affect only the skin, the condition now is known to involve internal organs. NSF can be extremely painful, causing the skin to contract to the point where movement is difficult or impossible. The condition has been reported only during the past 10 years and only among patients with abnormal kidney function, primarily those with advanced kidney disease. In 2006, an Austrian physician noted that NSF developed in several of his dialysis patients who had undergone MR imaging studies using gadolinium-containing contrast.

Reports of NSF in the medical literature have discussed only small numbers of cases and have not included comparative information from patients shown to not have the disorder. To better assess the prevalence of NSF among patients with advanced kidney disease and
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
Source:Eurekalert

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