Thickening and tightening of the skin from NSF

Nephrogenic Systemic Fibrosis, or Nephrogenic Fibrosing Dermopathy (NFD), is an uncommon disease that seems to occur only in patients with kidney disease. NSF is a skin disorder that results in the thickening of the skin and masses and extra pigmentation developing on areas of the skin. The condition can also affect internal organs and limit the range of motion of patients.

Evidence of the disease affecting areas besides the skin led to referring to the condition as “Nephrogenic Systemic Fibrosis.”

NFD can start and progress quite quickly, and can cause severe disability and, in some cases, even death. The disease can affect all ages, but most often affects individuals who have undergone dialysis for renal failure.

The Centers for Disease Control (CDC) has stated that gadolinium-containing contrast agents during magnetic resonance imaging (MRI) pose a significant risk factor for development of this disease among patients kidney disease. The U.S. Food and Drug Administration (FDA) has asked manufacturers to include a new boxed warning on the product labeling of all gadolinium-based contrast agents which are used to enhance the quality of magnetic resonance imaging (MRI).

The requested warning would state that patients with severe kidney insufficiency who receive gadolinium-based agents are at risk for developing Nephrogenic Systemic Fibrosis (NSF). It would also state that patients just before or just after liver transplantation, or those with chronic liver disease, are also at risk for developing NSF if they are experiencing kidney insufficiency of any severity.

Treatments for the disease are being researched, but there is currently no known cure for NSF.