Magnetic resonance imaging (MRI) is a common diagnostic tool that can be performed with or without the use of contrast agents. While an MRI without contrast is generally safe for people with all levels of kidney function, contrast dyes can pose certain risks for people with chronic kidney disease (CKD).*

Contrast MRI Risks

An MRI performed without contrast agents is straightforward and poses no special risks for people with kidney problems. This type of MRI does not involve the injection of any substances, making it a safer option for those with compromised kidney function.

When an MRI is performed with contrast dye, however, the situation becomes more complex. Contrast agents, often containing gadolinium (a rare-earth metal), enhance the clarity of the MRI images but can pose risks depending on their formulation and your kidney function.

The injection procedure alone carries the possibility of side effects, including:

• Dizziness
• Headaches
• Itching and rash
• Nausea
• Soreness at the injection site

The symptoms listed above could affect anyone receiving contrast dye, even people with healthy kidneys. 

People with CKD, however, are at greater risk of experiencing serious side effects such gadolinium poisoning and nephrogenic systemic fibrosis (NSF).

While newer gadolinium-based contrast agents are generally safe for patients with kidney disease, including those on dialysis, older agents can be problematic for people with moderate to advanced CKD.

How Minimize Risks 

There are several ways to help reduce the risks of using contrast dyes for MRI tests.

• Inform healthcare providers about your kidney issues before undergoing an MRI. 
• Your doctor can order blood tests to determine your kidney function and assess the risk.
• Experts recommend dialysis post-MRI (for patients already on dialysis) to help remove the contrast agent.
• If older gadolinium agents have been used, your doctor may recommend dialysis once a day for up to three days post-MRI to lower NSF risk.

Actively engage with your kidney care team to determine the safest approach for your MRI. 

*Chebib, F. (n.d.) MRI: Is gadolinium safe for people with kidney problems? Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/expert-answers/gadolinium/faq-20057772#:~

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