June 01, 2021

Can I safely get a MRI with contrast if I have kidney problems?

Q: I have an MRI with contrast scheduled, but I have kidney problems. Can MRI contrast agents hurt me?

A: While this was more of a concern in the past, it is less likely to be an issue today. An older type of contrast agent used during MRI presented a risk of harm for some people with kidney problems, but newer contrast agents can be provided more safely. And some MRI scans can be performed without any contrast agent.

MRI often uses a contrast agent that contains gadolinium (gad-oh-LIN-e-um) to enhance the scans. A contrast agent with gadolinium is injected into a vein and is primarily eliminated via your kidneys, then excreted through urine.

Some people with kidney problems may not properly eliminate gadolinium. In people with severe kidney problems, use of older gadolinium-containing contrast agents may result in a rare disease called nephrogenic systemic fibrosis (NSF). NSF can cause skin thickening and scarring of internal tissues. It can also be fatal.

Importantly, newer gadolinium agents, including those most commonly used at Mayo Clinic, have been shown to be safer, even for people with severe kidney disease. Recent consensus statements from the National Kidney Foundation and the American College of Radiology agree that newer types of gadolinium can be used in people with severe kidney disease and people on dialysis. Still, before having an MRI, make sure your doctor knows about your kidney problem.

If you already receive dialysis — a procedure that mimics kidney filtration and removes waste from your blood via a machine — your doctor may recommend scheduling the MRI before a dialysis session as a precaution.