Nephrogenic Systemic Fibrosis (NSF): Analysis of Tissue Gadolinium Levels

NCT ID: NCT01014754

Last Updated: 2014-12-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

24 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-08-31

Study Completion Date

2014-06-30

Brief Summary

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The primary objective of this study is to determine any causative or associated factors for the development of Nephrogenic Systemic Fibrosis (NSF), Nephrogenic Fibrosing Dermopathy (NFD), or related diagnosis. Our primary focus will be on the previous administration of gadolinium to these patients, but we will also look at other postulated causes and risk factors.

The secondary objective of this study is to assess tissue gadolinium (Gd) levels in five groups of subjects:

* Those affected by NSF.
* Those with normal kidney function who have undergone a medical imaging procedure using Gd-based contrast agent (GBCA) in the 2 years prior to a skin biopsy.
* Those with normal kidney function who have never been exposed to GBCA and have had a skin biopsy.
* Those on dialysis or with eGFR ≤ 30 ml/min/1.73 m2 who have had a medical imaging procedure using GBCA in the 2 years prior to skin biopsy.
* Those on dialysis or with eGFR ≤ 30 ml/min/1.73 m2 who have never been exposed to GBCA and have had skin biopsy.

We hypothesize that there is a correlation between the administration of Gd-containing agents usually associated with MRI procedures and the development of NSF in those with renal failure and some other predisposing condition. We also hypothesize that tissue Gd levels in those with NSF will be higher than in those who have been exposed to GBCA but do not have NSF. Of the two groups without NSF but with exposure to GBCA, we hypothesize that those with kidney dysfunction will have higher tissue Gd levels than those with normal kidney function. We hypothesize that in the two groups of subjects without exposure to GBCA, there will be no detectable levels of Gd, regardless of kidney function status.

Detailed Description

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Conditions

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Nephrogenic Systemic Fibrosis Nephrogenic Fibrosing Dermopathy

Study Design

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Observational Model Type

CASE_CONTROL

Study Groups

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NSF

Biopsy-proven diagnosis of NSF

No interventions assigned to this group

Kidney dysfunction plus gadolinium exposure

Those on dialysis or with eGFR ≤ 30 ml/min/1.73 m2 who have had a medical imaging procedure using GBCA in the 2 years prior to skin biopsy.

No interventions assigned to this group

Kidney dysfunction without gadolinium exposure

Those on dialysis or with eGFR ≤ 30 ml/min/1.73 m2 who have never been exposed to GBCA and have had skin biopsy.

No interventions assigned to this group

Normal kidney function with gadolinium exposure

Those with normal kidney function who have undergone a medical imaging procedure using Gd-based contrast agent (GBCA) in the 2 years prior to a skin biopsy.

No interventions assigned to this group

Normal kidneys without gadolinium exposure

Those with normal kidney function who have never been exposed to GBCA and have had a skin biopsy.

No interventions assigned to this group

Controls

Existing skin tissue from neonatal skin (\<6 months) will be used as controls, as they presumably have never been exposed to gadolinium

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Biopsy-confirmed diagnosis of NSF


* eGFR \>30
* Existing skin tissue sample
* Gadolinium exposure in 2 years preceding skin biopsy


Abnormal renal plus gadolinium exposure


* eGFR \<30 or on dialysis
* Existing skin tissue sample
* Gadolinium exposure in 2 years preceding skin biopsy


Abnormal renal without gadolinium exposure


* eGFR \<30 or on dialysis
* Existing skin tissue sample
* No gadolinium exposure ever


Normal renal without gadolinium exposure


* eGFR \>30
* Existing skin tissue sample
* No gadolinium exposure ever


Controls (neonatal)


* Existing skin biopsy tissue that was performed within the first 6 months of life

Exclusion Criteria

* Does not have NSF

Normal renal plus gadolinium exposure
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

Northwestern University

OTHER

Sponsor Role lead

Responsible Party

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Anne Laumann

Professor of Dermatology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anne Laumann, MBChB, MRCP(UK)

Role: PRINCIPAL_INVESTIGATOR

Northwestern University

Locations

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Northwestern University Feinberg School of Medicine, Department of Dermatology

Chicago, Illinois, United States

Site Status

Countries

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United States

References

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High WA, Ayers RA, Chandler J, Zito G, Cowper SE. Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis. J Am Acad Dermatol. 2007 Jan;56(1):21-6. doi: 10.1016/j.jaad.2006.10.047. Epub 2006 Nov 9.

Reference Type BACKGROUND
PMID: 17097388 (View on PubMed)

Khurana A, Greene JF Jr, High WA. Quantification of gadolinium in nephrogenic systemic fibrosis: re-examination of a reported cohort with analysis of clinical factors. J Am Acad Dermatol. 2008 Aug;59(2):218-24. doi: 10.1016/j.jaad.2008.04.010. Epub 2008 Jun 5.

Reference Type BACKGROUND
PMID: 18538448 (View on PubMed)

Cowper SE, Robin HS, Steinberg SM, Su LD, Gupta S, LeBoit PE. Scleromyxoedema-like cutaneous diseases in renal-dialysis patients. Lancet. 2000 Sep 16;356(9234):1000-1. doi: 10.1016/S0140-6736(00)02694-5.

Reference Type BACKGROUND
PMID: 11041404 (View on PubMed)

Other Identifiers

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NIH Grant #2 R01 CA102713-03A2

Identifier Type: -

Identifier Source: secondary_id

STU1460

Identifier Type: -

Identifier Source: org_study_id