Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Rosenkranz, AR; Grobner, T.
Conventional or Gadolinium containing contrast media: the choice between acute renal failure or Nephrogenic Systemic Fibrosis?
Wien Klin Wochenschr. 2007; 119(9-10):271-275
Doi: 10.1007/s00508-007-0801-8
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PubMed
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- Führende Autor*innen der Med Uni Graz
- Rosenkranz Alexander
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- Abstract:
- Nephrogenic Systemic Fibrosis ( NSF), also known as Nephrogenic Fibrosing Dermopathy ( NFD) has been described for the first time in renal transplant patients with poor transplant function in 1997 [ 1]. Since then, about 215 cases have been documented in the NSF/ NFD registry of the Yale University ( www. icnfdr. org). NSF is a fibrosing disorder that involves predominantly the skin but also affects systemic organs such as the liver, heart, lungs, diaphragm, and skeletal muscle [ 2]. The diagnosis of NSF is confirmed in a skin biopsy by specific histopathologic features, namely thickened dermis with bundles of collagen and surrounding clefts, mucin deposition and a proliferation of fibroblasts and elastic fibers. Signs of inflammation are absent, which makes this disorder a distinct entity [ 3]. It is associated with severe physical disability and potentially leads to death when several organ systems are involved [ 4]. The cause of NSF is unknown; however, the presence of an underlying impairment of kidney function is obviously a prerequisite. More than 90% of the cases described in the registry suffer from end stage renal disease, including both patients on haemodialysis as well as peritoneal dialysis. The remaining cases showed chronic kidney disease or developed NSF in the setting of acute renal failure. Thus, an underlying kidney disease is a prerequisite for the development of NSF. On the other hand, not every patient with renal impairment develops NSF. Therefore, a trigger initiating the fibrosing process has to be presumed.
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