An Updated Study to Determine Association between Gadolinium-Based Contrast Agents and Nephrogenic Systemic Fibrosis
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{"title"=>"An updated study to determine association between gadolinium-based contrast agents and nephrogenic systemic fibrosis", "type"=>"journal", "authors"=>[{"first_name"=>"Bin", "last_name"=>"Zhang", "scopus_author_id"=>"56535546900"}, {"first_name"=>"Long", "last_name"=>"Liang", "scopus_author_id"=>"56282966300"}, {"first_name"=>"Wenbo", "last_name"=>"Chen", "scopus_author_id"=>"56176323700"}, {"first_name"=>"Changhong", "last_name"=>"Liang", "scopus_author_id"=>"55339258500"}, {"first_name"=>"Shuixing", "last_name"=>"Zhang", "scopus_author_id"=>"35084570500"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "sgr"=>"84936854418", "doi"=>"10.1371/journal.pone.0129720", "scopus"=>"2-s2.0-84936854418", "pmid"=>"26076348", "pui"=>"605142966"}, "id"=>"0a5d4d62-6d2c-3b0d-9fc2-d977451ddf64", "abstract"=>"BACKGROUND Nephrogenic systemic fibrosis (NSF) is a rare but serious disorder disease affecting patients with advanced renal disease. Although multiple studies have indicated an association between gadolinium-based contrast agents (GBCAs) and NSF, some studies published after 2007 found no association. We therefore performed a meta-analysis to evaluate the association and analyze related (co)factors. METHODS Studies for analysis were identified by searching PubMed, Embase, and the Cochrane Central Register of Controlled Trials through December 2014. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using the fixed-effects model. Statistical heterogeneity was assessed by Q statistics and the I2 test. Publication bias was evaluated using Begg's test, Egger's test, funnel plot, and classic fail-safe N. Study quality was assessed using the Newcastle-Ottawa Scale. We also conducted sensitivity analyses, subgroup analyses and a cumulative meta-analysis. All statistical analyses were performed using Comprehensive Meta-Analysis 2.0. RESULTS A total of 14 studies (6,398 patients) met the inclusion criteria, but 3 were excluded since they reported no NSF events. Meta-analysis of controlled trials indicated a significant association between GBCAs and NSF development (OR = 16.504; 95% CI: 7.455-36.533; P < 0.001) and between gadodiamide and NSF (OR = 20.037; 95% CI: 3.725-107.784; P < 0.001). No statistical heterogeneity was observed across studies (P = 0.819, I2 = 0%; P = 0.874, I2 = 0%, respectively). Cumulative analysis demonstrated that the pooled ORs for association between GBCAs and NSF decreased post-2007 compared to pre-2007 (OR = 26.708; 95% CI: 10.273-69.436; P<0.001). CONCLUSIONS Although this updated meta-analysis found a significant association between GBCAs and the incidence of NSF in patients with advanced renal disease, the association decreased after 2007. More studies, especially randomized controlled trials, are warranted to examine the potential association between GBCAs other than gadodiamide and NSF.", "link"=>"http://www.mendeley.com/research/updated-study-determine-association-between-gadoliniumbased-contrast-agents-nephrogenic-systemic-fib", "reader_count"=>15, "reader_count_by_academic_status"=>{"Researcher"=>2, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>5, "Other"=>2, "Student > Master"=>3, "Student > Bachelor"=>2}, "reader_count_by_user_role"=>{"Researcher"=>2, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>5, "Other"=>2, "Student > Master"=>3, "Student > Bachelor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Engineering"=>2, "Mathematics"=>1, "Medicine and Dentistry"=>10}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>2}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>10}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>2}}, "reader_count_by_country"=>{"Netherlands"=>1, "Spain"=>2}, "group_count"=>0}

Scopus | Further Information

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/2113621"], "description"=>"<p>Forest plot of association between GBCAs and the development of NSF.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449859, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.g002", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Forest_plot_of_association_between_GBCAs_and_the_development_of_NSF_/1449859", "title"=>"Forest plot of association between GBCAs and the development of NSF.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-06-15 03:34:48"}
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  • {"files"=>["https://ndownloader.figshare.com/files/2113625"], "description"=>"<p>To assess the influence of single study on pooled estimate, we omitted one study at a time.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449863, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.g005", "stats"=>{"downloads"=>4, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sensitivity_analysis_plot_of_GBCAs_group_vs_Control_group_/1449863", "title"=>"Sensitivity analysis plot of GBCAs group vs Control group.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113626"], "description"=>"<p>Forest plot of association between Gadodiamide exposure and the development of NSF.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449864, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.g006", "stats"=>{"downloads"=>2, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Forest_plot_of_association_between_Gadodiamide_exposure_and_the_development_of_NSF_/1449864", "title"=>"Forest plot of association between Gadodiamide exposure and the development of NSF.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113628"], "description"=>"<p>To assess the influence of single study on pooled estimate, we omitted one study at a time.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449866, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.g007", "stats"=>{"downloads"=>2, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sensitivity_analysis_plot_of_gadodiamide_group_vs_control_group_/1449866", "title"=>"Sensitivity analysis plot of gadodiamide group vs. control group.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113629"], "description"=>"<p>Checklist for quality assessment of cohort and case-control study.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449867, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.t001", "stats"=>{"downloads"=>4, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Checklist_for_quality_assessment_of_cohort_and_case_control_study_/1449867", "title"=>"Checklist for quality assessment of cohort and case-control study.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113630"], "description"=>"<p>Note: ①/②/③represented retrospective cohort study, prospective cohort study, case-control study, respectively.</p><p>mo = months, yr = years.ESRD = end stage renal disease,CKD = chronic kidney disease,GBCAs = gadolinium-based</p><p>contrast agents, NSF = nephrogenic systemic fibrosis, NA = not available, Gd-DOTA = meglumine gadoterate</p><p>‡88.6% MR examinations were performed with gadodiamide (Ominscan), 11.4% were performed with Multihance, Magnevist,etc.</p><p>‡‡76% received gadoterate</p><p>†Seven types of GBCAs were used in MR examinations</p><p>* Five types of GBCAs</p><p>¶ Gadodiamide, gadopentetate dimeglumine, gadobutrol, etc.</p><p>**Seven types of GBCAs</p><p>$ Positive association was found between GBCAs and NSF</p><p>♯ Insufficiency evidence showed GBCAs was associated with the development of NSF.</p><p>The baseline characteristics of included studies.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449868, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.t002", "stats"=>{"downloads"=>1, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_baseline_characteristics_of_included_studies_/1449868", "title"=>"The baseline characteristics of included studies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113631"], "description"=>"<p>Note:—no star † cohort study ‡ case-control study</p><p>Quality assessment of included studies.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449869, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.t003", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Quality_assessment_of_included_studies_/1449869", "title"=>"Quality assessment of included studies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113632"], "description"=>"<p>Subgroup analyses on the incidence of NSF in various conditions.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449870, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.t004", "stats"=>{"downloads"=>4, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Subgroup_analyses_on_the_incidence_of_NSF_in_various_conditions_/1449870", "title"=>"Subgroup analyses on the incidence of NSF in various conditions.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113633"], "description"=>"<p>Note: NA = not applicable</p><p>* cumulative dose, median (mmol/kg)</p><p>†mean (mmol/kg)</p><p>‡median (ml)</p><p>※ mean±sd(ml)</p><p>Dose-response relationship between gadolinium and NSF.</p>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449871, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0129720.t005", "stats"=>{"downloads"=>9, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Dose_response_relationship_between_gadolinium_and_NSF_/1449871", "title"=>"Dose-response relationship between gadolinium and NSF.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-06-15 03:34:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/2113634", "https://ndownloader.figshare.com/files/2113635"], "description"=>"<div><p>Background</p><p>Nephrogenic systemic fibrosis (NSF) is a rare but serious disorder disease affecting patients with advanced renal disease. Although multiple studies have indicated an association between gadolinium-based contrast agents (GBCAs) and NSF, some studies published after 2007 found no association. We therefore performed a meta-analysis to evaluate the association and analyze related (co)factors.</p><p>Methods</p><p>Studies for analysis were identified by searching PubMed, Embase, and the Cochrane Central Register of Controlled Trials through December 2014. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using the fixed-effects model. Statistical heterogeneity was assessed by Q statistics and the I<sup>2</sup> test. Publication bias was evaluated using Begg’s test, Egger’s test, funnel plot, and classic fail-safe N. Study quality was assessed using the Newcastle-Ottawa Scale. We also conducted sensitivity analyses, subgroup analyses and a cumulative meta-analysis. All statistical analyses were performed using Comprehensive Meta-Analysis 2.0.</p><p>Results</p><p>A total of 14 studies (6,398 patients) met the inclusion criteria, but 3 were excluded since they reported no NSF events. Meta-analysis of controlled trials indicated a significant association between GBCAs and NSF development (OR = 16.504; 95% CI: 7.455–36.533; <i>P</i> < 0.001) and between gadodiamide and NSF (OR = 20.037; 95% CI: 3.725–107.784; <i>P</i> < 0.001). No statistical heterogeneity was observed across studies (<i>P</i> = 0.819, <i>I<sup>2</sup></i> = 0%; <i>P</i> = 0.874, <i>I<sup>2</sup></i> = 0%, respectively). Cumulative analysis demonstrated that the pooled ORs for association between GBCAs and NSF decreased post-2007 compared to pre-2007 (OR = 26.708; 95% CI: 10.273–69.436; <i>P</i><0.001).</p><p>Conclusions</p><p>Although this updated meta-analysis found a significant association between GBCAs and the incidence of NSF in patients with advanced renal disease, the association decreased after 2007. More studies, especially randomized controlled trials, are warranted to examine the potential association between GBCAs other than gadodiamide and NSF.</p></div>", "links"=>[], "tags"=>["publication bias", "NSF events", "sensitivity analyses", "Fibrosis BackgroundNephrogenic", "NSF development", "Q statistics", "association", "or", "Cumulative analysis", "Controlled Trials", "study quality", "Updated Study", "Cochrane Central Register", "ci", "Statistical heterogeneity", "inclusion criteria", "disorder disease", "GBCA", "December 2014. Pooled odds ratios", "subgroup analyses", "2 test"], "article_id"=>1449872, "categories"=>["Biological Sciences"], "users"=>["Bin Zhang", "Long Liang", "Wenbo Chen", "Changhong Liang", "Shuixing Zhang"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0129720.s001", "https://dx.doi.org/10.1371/journal.pone.0129720.s002"], "stats"=>{"downloads"=>8, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_An_Updated_Study_to_Determine_Association_between_Gadolinium_Based_Contrast_Agents_and_Nephrogenic_Systemic_Fibrosis_/1449872", "title"=>"An Updated Study to Determine Association between Gadolinium-Based Contrast Agents and Nephrogenic Systemic Fibrosis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-06-15 03:34:48"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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