Gadolinium and NSF Risk

Reads nephrogenic systemic fibrosis risk from the gadolinium agent group and the kidney state.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Agent group
Group II: gadobenate, gadobutrol, gadoterate, gadoteridol, gadopiclenol
Kidney function
Stable chronic kidney disease, eGFR below 30

Result: a group II agent below an eGFR of 30 carries a risk possibly not distinguishable from zero

The tool opens with these values already filled in. Replace them with your own.

What the result means

Group I
Gadodiamide, gadopentetate, gadoversetamide. Associated with the greatest number of nephrogenic systemic fibrosis cases; this is the combination the concern was built on.
Group II
Gadobenate, gadobutrol, gadoterate, gadoteridol, gadopiclenol. Few or no unconfounded cases; the risk may not be distinguishable from zero, even below an eGFR of 30 or on dialysis.
Group III
Gadoxetate. Limited data, which is not the same as reassurance and not the same as the group I signal.
The old blanket rule
That gadolinium is contraindicated below an eGFR of 30 came from group I experience. It has not applied to group II agents for years.
Dialysis
After the scan it is not a preventive measure. Starting dialysis solely to remove contrast has never been shown to prevent the disease.
Acute kidney injury
Its own category, not stable disease at the same number. A filtration rate computed during an acute injury does not describe a steady state.

What you enter

  • Agent group
  • Kidney function
How this is calculated

American College of Radiology. ACR Manual on Contrast Media, section on nephrogenic systemic fibrosis and gadolinium-based contrast agents. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.