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NDT Advance Access first published online on July 7, 2007
This version published online on September 21, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm430
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Nephrogenic systemic fibrosis—the need for a multidisciplinary approach

Joëlle L. Nortier1,2 and Véronique del Marmol1,2

1Department of Nephrology and 2Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, B-1070 Brussels, Belgium

Correspondence and offprint requests to: Joëlle L Nortier, MD, PhD, Nephrology, Dialysis and Renal Transplantation, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik, 808, Brussels, Belgium, Email: jnortier@ulb.ac.be

Keywords: dialysis; gadolinium-based contrast agents; gadodiamide; nephrogenic fibrosing dermopathy; nephrogenic systemic fibrosis; severe renal dysfunction

The first 150 words of the full text of this article appear below.



   Introduction
 
The emergence of a new type of fibrosing dermopathy in advanced CKD patients is currently changing the cooperation between nephrologists and rheumatologists, dermatologists and radiologists. Many aspects of the pathophysiology of this clinical entity, initially called ‘nephrogenic fibrosing dermopathy’ (NFD) and now replaced by the term ‘nephrogenic systemic fibrosis’ (NSF), are still unknown, as regards a potential systemic involvement of the fibrosis process. This Editorial Comment summarizes the characteristics of the disease and the proposed aetiological mechanisms, focusing on the relationship between NSF and exposure to gadolinium-based MR contrast agents, as reported by Marckmann et al. in the present issue. The recommendations made by the Food and Drug Administration and the guidelines released by the European Society of Urogenital Radiology together with the UK Commission on Human Medicines are updated.



   Definition and diagnosis
 
Reported for the first time in 1997 and recognized a few years later [1–5], NFD is a rare . . . [Full Text of this Article]



   Physiopathological aspects
 


   Gadodiamide-related NSF
 


   Proposed mechanisms of gadolinium-based contrast agents triggered NSF
 


   Therapeutic strategies
 


   Conclusion and recommendations
 

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