Nephrogenic Fibrosing Dermopathy

Treatment

Nephrogenic fibrosing dermopathy (NFD) is a chronic, progressive condition. There is no cure for the disease and no treatment is consistently successful in halting or reversing the progression of the disease. Some medications help some patients and some patients report marginal improvement and stabilization years after its onset. The lesions may be more treatable earlier in the disease course, less treatable after muscles are affected.

The following treatments for NFD continue to be investigated:

• Reduced EPO dosage: Many people with kidney disease have anemia (low levels of red blood cells). Erythropoietin (EPO), a hormone that promotes the production of red blood cells, is often used to treat anemia. Reducing the doses of EPO can help some patients with NFD.
• Oral steroids (prednisone): These medications have helped some patients, but due to their side effects, their use is largely discouraged.
• Topical Dovonex: Some patients report improvement from this treatment in early stages of NFD.
• Photopheresis: A therapy where the blood is removed, exposed to ultraviolet radiation and then returned to the patient.
• Plasmapheresis: Removing the liquid portion of the blood (plasma) has been shown to improve NFD in some patients with dual liver/kidney transplants.
• Thalidomide: Some patients improve while taking this drug, but its long-term side effects may be an issue.
• Plaquenil: Some patients benefit from this drug, but side effects can affect the eyes and it must be closely monitored.
• Minocycline (or similar antibiotics): Some patients have reported benefit from this medication, but it can affect the intestinal tract and lead to fungal infections and sun sensitivity.
• Pentoxyfilline: There are some reports of success with this medication which theoretically decrease the viscosity of blood and aids circulation and can have anti-oxidant effects.
• Physical therapy: Physical therapy, particularly swimming, may help slow the progression of joint problems.