Joshua DeAguero, Kidney Institute of New Mexico, University of New Mexico Health Science Center, Albuquerque, NM, USA. University of New Mexico Health Science Center, Albuquerque, NM, USA. New Mexico Veterans Administration Health Care System, Albuquerque, NM, USA.Follow
Tamara Howard, University of New Mexico Health Science Center, Albuquerque, NM, USA.
Donna Kusewitt, University of New Mexico Health Science Center, Albuquerque, NM, USA.
Adrian Brearley, Department of Earth and Planetary Sciences, University of New Mexico, Albuquerque, NM, USA.
Abdul-Mehdi Ali, Department of Earth and Planetary Sciences, University of New Mexico, Albuquerque, NM, USA.
James H. Degnan, Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA.
Stephen Jett, Chan Zuckerberg Initiative, Redwood City, CA, USA.
John Watt, Center for Integrated Nanotechnologies, Los Alamos National Laboratory, Los Alamos, NM, 87545, USA.
G Patricia Escobar, Kidney Institute of New Mexico, University of New Mexico Health Science Center, Albuquerque, NM, USA. University of New Mexico Health Science Center, Albuquerque, NM, USA. New Mexico Veterans Administration Health Care System, Albuquerque, NM, USA.
Karol Dokladny, Kidney Institute of New Mexico, University of New Mexico Health Science Center, Albuquerque, NM, USA. University of New Mexico Health Science Center, Albuquerque, NM, USA. New Mexico Veterans Administration Health Care System, Albuquerque, NM, USA.
Brent Wagner, Kidney Institute of New Mexico, University of New Mexico Health Science Center, Albuquerque, NM, USA. University of New Mexico Health Science Center, Albuquerque, NM, USA. New Mexico Veterans Administration Health Care System, Albuquerque, NM, USA.Follow

Document Type

Article

Publication Date

2-4-2023

Abstract

The leitmotifs of magnetic resonance imaging (MRI) contrast agent-induced complications range from acute kidney injury, symptoms associated with gadolinium exposure (SAGE)/gadolinium deposition disease, potentially fatal gadolinium encephalopathy, and irreversible systemic fibrosis. Gadolinium is the active ingredient of these contrast agents, a non-physiologic lanthanide metal. The mechanisms of MRI contrast agent-induced diseases are unknown. Mice were treated with a MRI contrast agent. Human kidney tissues from contrast-naïve and MRI contrast agent-treated patients were obtained and analyzed. Kidneys (human and mouse) were assessed with transmission electron microscopy and scanning transmission electron microscopy with X-ray energy-dispersive spectroscopy. MRI contrast agent treatment resulted in unilamellar vesicles and mitochondriopathy in renal epithelium. Electron-dense intracellular precipitates and the outer rim of lipid droplets were rich in gadolinium and phosphorus. We conclude that MRI contrast agents are not physiologically inert. The long-term safety of these synthetic metal-ligand complexes, especially with repeated use, should be studied further.

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