In which patients should MRI with gadolinium be avoided?

MRI with gadolinium-based contrast agents should be avoided in patients with renal failure, particularly those with a creatinine level greater than 1.5 mg/dL. This is primarily due to the risk of nephrogenic systemic fibrosis (NSF), a serious condition that can occur in patients with severe renal impairment. Gadolinium can accumulate in the body when renal function is compromised, leading to this potentially life-threatening condition where fibrosis occurs in various organs and tissues.

In contrast, patients with diabetes might have coexisting renal issues but do not inherently need to avoid gadolinium unless there is confirmed renal failure. Patients with hypertension do not have a direct contraindication to gadolinium use. Similarly, while patients receiving anticoagulants need to be monitored carefully to prevent bleeding complications during the procedure, their renal function is the primary consideration when determining the safety of gadolinium administration. Thus, patients with renal failure represent a clear and significant risk for adverse effects associated with the use of gadolinium.