MRI disease is a very rare disease associated with the use of certain contrast agents in magnetic resonance imaging scans performed on patients with impaired kidney function. In these patients, the contrast agents have been linked with the development of a condition called nephrogenic systemic fibrosis (NSF), where collagen builds up in the body, eventually leading to organ damage and death. Treatment for this condition relies on trying to correct the underlying kidney problem, while also providing supportive care, and it is ultimately fatal.
The contrast agents linked with the development of MRI disease all appear to contain gadolinium, a type of metal. In people with healthy kidneys, the kidneys process the metal after the MRI and the body safely excretes it. People with impaired kidneys cannot metabolize the contrast agent appropriately, and it apparently contributes to the development of NSF. Controlling for other known causes and risk factors, NSF and a history of the usage of MRIs with contrast have been clearly linked in a number of patients.
In 2010, the Food and Drug Administration in the United States responded to concerns about MRI disease by applying its toughest warning, the black box label, to contrast agents containing gadolinium. The label warns against using these materials in patients with renal impairment, including patients in renal failure and patients with acute kidney injuries. While some manufacturers protested the warning label, the FDA felt it was appropriate on the basis of the information it reviewed in the process of studying the connection between MRI scans and the development of NSF in patients.
People with kidney disease are at increased risk in general when taking any medication metabolized by the kidneys, because their bodies may not be able to eliminate the medication in a timely fashion. People with a history of kidney problems should discuss the contrast agents being used in medical imaging studies to confirm they are safe. It is also advisable to read medication warnings carefully and to make sure doctors and pharmacists are aware of the kidney issues so they can catch medication errors before they happen.
Just receiving an MRI is not dangerous for a patient with kidney problems, and there are other contrast agents safe for use in such patients. MRI disease is linked specifically with the use of contrast agents containing gadolinium. Development of conditions like MRI disease is one reason agencies like the FDA engage in ongoing surveillance of products approved for medical use, to check for the development of conditions that only appear years after exposure.
