Volume 73, Issue 12, Pages (June 2008)

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Volume 73, Issue 12, Pages 1413-1418 (June 2008) Cardiac and vascular metal deposition with high mortality in nephrogenic systemic fibrosis  S. Swaminathan, W.A. High, J. Ranville, T.D. Horn, K. Hiatt, M. Thomas, H.H. Brown, S.V. Shah  Kidney International  Volume 73, Issue 12, Pages 1413-1418 (June 2008) DOI: 10.1038/ki.2008.76 Copyright © 2008 International Society of Nephrology Terms and Conditions

Figure 1 Nephrogenic systemic fibrosis and limb ischemia after magnetic resonance angiography. New-onset limb ischemia (a) and nephrogenic systemic fibrosis (b) 1 month after exposure to gadolinium contrast media in a patient with end-stage renal disease on peritoneal dialysis. A significant amount of gadolinium (49 μg g-1) was detected in the aorta 36 days after gadolinium-based contrast exposure. Kidney International 2008 73, 1413-1418DOI: (10.1038/ki.2008.76) Copyright © 2008 International Society of Nephrology Terms and Conditions

Figure 2 Coronary artery disease with vascular gadolinium deposition. (a) Coronary artery disease in a patient with nephrogenic systemic fibrosis with CD34-positive cells. Appreciable quantities of gadolinium were present in the vessel wall. (b and c) Iron particles demonstrated in the vessel wall using electron scanning microscopy. Kidney International 2008 73, 1413-1418DOI: (10.1038/ki.2008.76) Copyright © 2008 International Society of Nephrology Terms and Conditions

Figure 3 Myocardial fibrosis in a patient with nephrogenic systemic fibrosis and recurrent cardiac arrythmias. Appreciable quantities of gadolinium (442 μg g-1) were present in the myocardial tissues. Kidney International 2008 73, 1413-1418DOI: (10.1038/ki.2008.76) Copyright © 2008 International Society of Nephrology Terms and Conditions

Figure 4 X-ray fluorescence microprobe for detection of gadolinium in the myocardium of an NSF patient with myocardial fibrosis shown in Figure 3. The tissue demonstrates strong gadolinium emission spectra. Kidney International 2008 73, 1413-1418DOI: (10.1038/ki.2008.76) Copyright © 2008 International Society of Nephrology Terms and Conditions