NSF

Q: All of the following have been considered as risk factors for Nephrogenic systemic fibrosis (NSF) except? 

 A) high-dose erythropoietin treatment
B) metabolic acidosis
C) proinflammatory conditions
D) elevated calcium levels 
E) elevated phosphate levels


Answer: D 

Nephrogenic systemic fibrosis (NSF) though rare but can be a devastating side effect of gadolinium administration in patients with severe renal dysfunction. Awareness is still not very optimum for this condition. Literature is also very nascent as well. Few of the risk factors identified are high-dose erythropoietin treatment, metabolic acidosis, proinflammatory conditions, elevated iron, and phosphate levels. Gadolinium is itself a calcium channel blocker and high calcium level is not a risk factor identified yet.

#pharmacology
#nephrology


References:

Abu-Alfa AK. Nephrogenic systemic fibrosis and gadolinium-based contrast agents. Adv Chronic Kidney Dis 2011; 18:188.

Zhang B, Liang L, Chen W, et al. An Updated Study to Determine Association between Gadolinium-Based Contrast Agents and Nephrogenic Systemic Fibrosis. PLoS One 2015; 10:e0129720.