UMass Chan Medical School Faculty Publications


Gadolinium-Induced Fibrosis

UMMS Affiliation

Division of Rheumatology, Department of Medicine

Publication Date


Document Type



Rheumatology | Skin and Connective Tissue Diseases


Gadolinium-based contrast agents (GBCAs), once believed to be safe for patients with renal disease, have been strongly associated with nephrogenic systemic fibrosis (NSF), a severe systemic fibrosing disorder that predominantly afflicts individuals with advanced renal dysfunction. We provide a historical perspective on the appearance and disappearance of NSF, including its initial recognition as a discrete clinical entity, its association with GBCA exposure, and the data supporting a causative relationship between GBCA exposure and NSF. On the basis of this body of evidence, we propose that the name gadolinium-induced fibrosis (GIF) more accurately reflects the totality of knowledge regarding this disease. Use of high-risk GBCAs, such as formulated gadodiamide, should be avoided in patients with renal disease. Restriction of GBCA use in this population has almost completely eradicated new cases of this debilitating condition. Emerging antifibrotic therapies may be useful for patients who suffer from GIF.


Gd, chronic kidney disease, fibrosing disorders, gadolinium-based contrast agents, magnetic resonance imaging, nephrogenic systemic fibrosis

DOI of Published Version



Annu Rev Med. 2016;67:273-91. doi: 10.1146/annurev-med-063014-124936. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Annual review of medicine

PubMed ID