Is contrast enhanced MRI useful in CKD

Can contrast enhanced MRI be done in patients with CKD?

• Yes. Early-generation, linear gadolinium agents are the only ones in which NSF was reported. The newer cyclical agents bind gadolinium more tightly and are approved down to an eGFR of 30 mL/min per 1.73m ² .

Most of these new agents have no documented cases of NSF, even in patients with eGFR below 30 mL/min per 1.73 m ² or with dialysis (per some studies).

Gadolinium Based MRI Contrast Agents

Name	Trade Name	Molecular Structure	Type	NSF Reported
Gadotate	Dotarem	Macrocyclic ionic	Extracellular a	No
Gadodiamide	Omniscan	Linear ionic	Extracellular	Yes
Gadopentetate	Magnevist	Linear ionic	Extracellular	Yes
Gadobenate	Multihance	Linear ionic	Extracellular	No
Gadoteridol	Prohance	Macrocyclic nonionic	Extracellular	No
Gadoversetamide	Optimark	Linear nonionic	Extracellular	Yes
Gadobutrol	Gadavist	Macrocyclic nonionic	Extracellular	No
Gad oxetate	Eovist	Linear ionic	Hepatobiliary b	No
Gadofosveset	Ablavar	Macrocyclic albumin bound	Bloodpool c	No

MRI , Magnetic resonance imaging; NSF , nephrogenic systemic fibrosis.

a Gives general tissue enhanceement.

b Evaluate liver masses.

c Evaluates vasculature.