Nephrogenic Systemic Fibrosis: Clinical Review and Education for Nurse Practitioners

In the past decade, nephrogenic systemic fibrosis has emerged as a new, severe, painful, disabling, and fibrosing disease of the skin and systemic tissues associated with the common denominators, advanced renal insufficiency, and exposure to gadolinium, an element used in magnetic resonance procedures. This disease mimics other cutaneous diseases with thickening and hardening of the skin of the extremities, yet it uniquely affects numerous organ systems such as the lungs, liver, or muscles. There is no effective treatment, making prevention the priority. Practitioners must identify patients at risk and exercise extreme caution when ordering magnetic resonance procedures in those patients.