Is gadolinium safe for people with kidney problems?

I'm scheduled for an MRI and I have kidney problems. Will I be OK having an MRI?

It depends on the type of magnetic resonance imaging (MRI) scan you're scheduled to have — an MRI with contrast or an MRI without contrast. Contrast agents, including gadolinium, are used to enhance some MRI scans. Contrast agents are injected into a vein in your hand or arm. Not all MRIs require a contrast agent.

There are no special concerns for people with kidney problems having an MRI without contrast.

However, there are concerns if people with kidney problems are given a gadolinium-based contrast agent during their MRI — especially if they have severe kidney failure (renal insufficiency).

Gadolinium-containing contrast agents may increase the risk of a rare, but serious, disease called nephrogenic systemic fibrosis in people with severe kidney failure. Nephrogenic systemic fibrosis triggers thickening of the skin, organs and other tissues. There's no effective treatment for this serious, debilitating disease.

Before you have an MRI, ask your doctor if a gadolinium-based contrast agent will be used. If the answer is yes, tell your doctor about your history of kidney problems. If possible, your doctor may select a different imaging test. In cases where an MRI with gadolinium is necessary despite the potential risks, your doctor may use the lowest possible dose of the form of gadolinium that has been associated with the fewest complications as well as consider hemodialysis immediately after the MRI with gadolinium.