[Nephrogenic systemic fibrosis. Medical detective work in the 21st century].

Nephrogenic systemic fibrosis is a new disease entity which was first described in 2000. It is characterized by dermal and visceral fibrosis in patients with impaired renal function. Recently, the etiology of this disease has been unveiled. The application of gadolinium-containing contrast media in patients with decreased renal function can lead to gadolinium deposition in various tissues which induces the fibrotic process. Numerous publications within the last few months have supported this hypothesis and have led to recommendations by the health authorities to carefully weigh the benefits and risks of using gadolinium in patients with impaired renal function.