Treatment at Mayo Clinic

By Mayo Clinic Staff

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There is no cure for nephrogenic systemic fibrosis, and no treatment is consistently successful in halting or reversing the progression of the disease. The lesions may be more treatable earlier in the disease course, but less treatable after muscles are affected. Nephrogenic systemic fibrosis only occurs rarely, making it difficult to conduct large studies.

Mayo Clinic doctors have experience with the following treatments for nephrogenic systemic fibrosis. More research is needed to determine if these treatments help, but they have shown limited success in some people.

  • Hemodialysis. In patients with severely reduced kidney function, performing hemodialysis immediately after receiving gadolinium-containing contrast may decrease the possibility of nephrogenic systemic fibrosis.
  • Physical therapy. Physical therapy that helps stretch the involved limbs may help slow the progression of joint contractures and preserve movement.
  • Kidney transplant. For people who are appropriate candidates, improvement in renal function because of a kidney transplant may help improve nephrogenic systemic fibrosis over time.
  • Ultraviolet A phototherapy. Exposure of the skin to ultraviolet A light may reduce the skin thickening and hardening, but it's unclear if the treatment penetrates deeply enough into the skin to be effective.
  • Reduced erythropoietin (EPO) dosage. Reducing the doses of EPO can help some people who have nephrogenic systemic fibrosis.

These medications have been shown to help some people, but their side effects limit their use. More research is needed to determine if these options help:

  • Topical cream. Some people report improvement from calcipotriene in early stages of the disease.
  • Oral or topical steroids. These medications have helped some people, but due to their side effects, their use is largely discouraged.
  • Thalidomide. Some people improve while taking this drug, but its long-term side effects may be an issue.
  • Hydroxychloroquine. Some people benefit from this drug, but side effects can affect the eyes, and it must be closely monitored.
  • Minocycline. Some people have reported benefit from this medication, but it can affect the intestinal tract and lead to fungal infections and sun sensitivity.
  • Pentoxifylline. There is limited success with this medication, which theoretically decreases the thickness and stickiness (viscosity) of blood, aiding circulation.
  • Imatinib. Although this treatment shows some promise in reducing skin thickening and tightening, more research is needed.
  • Sodium thiosulfate. Possible benefit has been shown using this medication, but more research is needed.
Jun. 17, 2013

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