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B. Wagner, M.D. 🇺🇸 Profile picture
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Jun 9, 2019 • 4 tweets • 4 min read
“[T]he American College of Radiology have categorized the various ligands into different safety classes ... despite being grounded in purely observational data,” physiology.org/doi/full/10.11…
#gadolinium ☠️ #patientsafety #radiology #Nephrology
The “American College of Radiology] Committee on Drugs and Contrast Media considers the risk of [‘nephrogenic’ systemic fibrosis] among patients exposed to standard or lower than standard doses of group II [gadolinium-based contrast agents] is ... possibly nonexistent...”
The American College of Radiology, based on more opinion than evidence, guided Group II agents—such as MultiHance—as having “sufficiently low or possibly nonexistent” risk for gadolinium-induced systemic fibrosis. acr.org/Clinical-Resou…
#gadolinium ☠️ #radiology ☢️ #Nephrology
The result is that the adverse event for ‘nephrogenic’ systemic fibrosis is now the number one ranked adverse event with the American College of Radiology Group II agent, MultiHance per the FDA Adverse Events Reporting System.
#gadolinium ☠️ #patientsafety #radiology ☢️

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B. Wagner, M.D. 🇺🇸 Profile picture
May 5, 2020
We advise clinicians to do the following to improve patient safety:

1) Limit the volume of administered gadolinium-based contrast agents when used
kidney360.asnjournals.org/content/early/…

#gadolinium
☢️#radiology
#nephrology
🏥#patientsafety
#risk #management
#medical #ethics
#FOAMed
2) increase patient education, incorporate informed consent and shared decision making when GBCA administration occurs;

kidney360.asnjournals.org/content/early/…

#gadolinium
☢️#radiology
#nephrology
🏥#patientsafety
#risk #management
#medical #ethics
#FOAMed
3) maintain careful institutional records of administered agents along with the volume and frequency,

kidney360.asnjournals.org/content/early/…

#gadolinium
☢️#radiology
#nephrology
🏥#patientsafety
#risk #management
#medical #ethics
#FOAMed
Read 4 tweets
B. Wagner, M.D. 🇺🇸 Profile picture
Jan 23, 2020
Now: “Dialyzing the Undocumented: Driving Policy with Data”
by Dr. Lilia Cervantes, M.D.
Denver Health Medical Center and the University of Colorado Anschutz Medical Group
@Cervantes_Lily1 University of New Mexico Health Science Center Department of Medicine Grand Rounds
“Patients sometimes consumed foods [knowingly] high in potassium,” in order to gain admission — @Cervantes_Lily1 University of New Mexico Health Science Center Department of Medicine Grand Rounds
“So, you are asking me to keep a patient sicker so you can make more money? I am sorry, that is not why I became a physician,” @Cervantes_Lily1 University of New Mexico Health Science Center Department of Medicine Grand Rounds
Read 16 tweets
B. Wagner, M.D. 🇺🇸 Profile picture
Oct 5, 2019
“Around 2012 or 2013, researchers identified evidence that gadolinium retention was connected to illness in patients with normal kidney function.” scholar.google.com/scholar_case?c…
“In September 2017, after the FDA voted to add concerns about gadolinium retention on warning labels, [gadolinium-based contrast agent] manufacturers, including Defendants, issued a new joint warning to patients with normal kidney function.” scholar.google.com/scholar_case?c…
“The warning [RE: #gadolinium retention] also directed physicians to advise patients of these concerns.”

Consent: valued in the United States since the Nuremberg trials of 1947 🇺🇸 scholar.google.com/scholar_case?c…

☢️#radiology
🥼#nephrology
🏥#publichealth ⚠️#patientsafety
💉#MRIdye
Read 4 tweets
B. Wagner, M.D. 🇺🇸 Profile picture
May 13, 2019
“Gadolinium-based contrast agents: Stimulators of myeloid-induced renal fibrosis and major metabolic disruptors,“ is now in press—sciencedirect.com/science/articl…

#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
#dermatology
#nephrology
“Gadolinium-based contrast agents are not biologically inert,” sciencedirect.com/science/articl…

#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
#dermatology
#nephrology
#rheumatology
Gadolinium-based “magnetic resonance imaging contrast agent treatment impaired renal function, induced pathologic damage, and increased kidney fibrosis,” sciencedirect.com/science/articl…

#gadolinium
#nephrology
#radiology ☢️
#patientsafety
#publichealth
#toxicology
Read 11 tweets
B. Wagner, M.D. 🇺🇸 Profile picture
Apr 30, 2019
“[I]t is known that during those at least 6 weeks [after exposure to gadolinium-based contrast agent] equilibrium has not been reached and [gadolinium] can be measured for all [gadolinium-based contrast agents] in tissue,” fda.gov/downloads/Advi…

#gadolinium
🧠
☢️
“It is important to note that the exact mechanism and in particular other co-factors that are likely needed to trigger [‘nephrogenic’ systemic fibrosis] are still unknown,” fda.gov/downloads/Advi…

#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
“[T]he levels of gadolinium in the body considered normal in the absence of any [gadolinium-based contrast agent] exposure is, for practical purposes, zero,” fda.gov/downloads/Advi…

#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
Read 4 tweets
B. Wagner, M.D. 🇺🇸 Profile picture
Apr 28, 2019
“Gadolinium is a rare earth element. It is a toxic heavy metal,” foodphoenix.blogspot.com/2019/04/litera…

#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
#dermatology
#nephrology
#rheumatology
“Notably, in recently published rodent studies, complete clearance of the brain took up to 6 months after injection of a large amount of” gadolinium-based contrast agents. journals.lww.com/investigativer… @HrsQuiet
#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
“[S]o it can be assumed that the total clearance—if achieved at all—might also take months in humans,” after gadolinium-based contrast administration— journals.lww.com/investigativer… @HrsQuiet
#gadolinium
#neurology 🧠
#radiology ☢️
#patientsafety
#publichealth
#toxicology
Read 4 tweets

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