Gadolinium Beliefs

Poll results from last week:  The majority of individuals (60%) felt that it was definitely unsafe giving gadolinium to ESRD patients, with 45% of individuals also agreeing that it was unsafe in CKD stage 4.  As is consistent with the literature, most people did not feel that giving an individual with CKD Stage 3 gadolinium to be a problem.  The epidemiological data linking gadolinium to nephrogenic systemic fibrosis (NSF) (summarized nicely in this review by Dr. Derrick Todd of my home institution, Mass General Hospital) has been somewhat controversial given the frequency with which gado is administered and the relative rarity of NSF, but appears to be gaining acceptance.  Whether or not dialysis immediately after gadolinium exposure is effective in preventing NSF is still quite controversial, but my hospital has incorporated it into its policy to dialyze CKD4/5/ESRD patients exposed to gadolinium as the compound is removed by serial dialysis.  

Check out the new, politically-themed poll question of the week!