Which medication is associated with a risk of nephrogenic systemic fibrosis?

The medication associated with a risk of nephrogenic systemic fibrosis is gadolinium. Gadolinium is a contrast agent commonly used in magnetic resonance imaging (MRI) for enhancing the quality of the images. In individuals with severe kidney dysfunction, the use of gadolinium-based contrast agents has been linked to the development of nephrogenic systemic fibrosis (NSF), a serious condition characterized by thickening and hardening of the skin, and potential involvement of internal organs.

The risk of NSF arises because the kidneys are responsible for excreting gadolinium from the body. When kidney function is impaired, gadolinium can accumulate, leading to toxic effects that contribute to the development of NSF. This is particularly concerning in patients with pre-existing kidney disease or those requiring multiple imaging studies with gadolinium contrast.

In contrast, the other medications listed—glatiramer acetate, interferon beta-1a, and natalizumab—are used in the treatment of multiple sclerosis but do not carry the same association with nephrogenic systemic fibrosis. Their mechanisms of action, side effect profiles, and safety considerations do not involve the nephrotoxic potential that gadolinium contrast agents exhibit in certain patient populations.