GBCAs and NSF: Why Did It Happen and What Have We Learned?

Jeffrey C. Weinreb ¹

The association between GBCAs and NSF has led the medical community to ask, Why did it happen and what have we learned? A confluence of factors conspired to cause a lag in identifying this association, including the perceived advantage compared with iodinated agents in CIN, high dose CE-MRA, physician engagement, record keeping, pharmcovigilance infrastructure, and new dialysis regimens. < 500 cases of NSF are reported, and severe forms occur only in patients with AKI or severe to end-stage CKD, usually on dialysis. Most high risk patients do not develop NSF, and the number of new cases