What is the Treatment for NSF?
NSF gets worse over time and as of yet there is no cure. There is still no established treatment for NSF, but it appears that improvement of kidney function seems to slow the disease down. Many different treatments have been tried and are currently being investigated. Following are some of these treatments:
Extracorporeal photopheresis (ECP) - a medical therapy used to treat skin cancer and other conditions. The patient's blood is drawn intravenously and white blood cells are separated before the blood is returned to the body. The white blood cells are then mixed with a liquid medication that makes the cancer cells sensitive to ultraviolet light. The white blood cells are then exposed to ultraviolet light which kills the cancer cells. The blood is then returned to the body.
Plasmapheresis - a medical therapy used to treat myasthenia gravis and other autoimmune conditions. The patient's blood is drawn intravenously and the fluid part of the blood (plasma) is separated from the blood cells. The cells are returned to the body and the plasma is discarded and replaced with a plasma substitute. This has helped some NSF patients with dual liver/kidney transplants.
Oral steroids (Prednisone) - Medications used to treat a wide variety of conditions, including diseases of the skin, i.e., psoriasis, Stevens-Johnson syndrome, and severe seborrhea. These have helped some NSF patients but are not recommended because of their side effects.
Reduction of ESAs - Many kidney patients are treated with anemia drugs called erythropoiesis-stimulating agents (ESAs), i.e., Procrit, Aranesp, and Epogen. Lowering the dosage of these drugs can sometimes help NSF symptoms.
Topical Dovonex - Medicated cream or ointment used to treat psoriasis. This may improve skin lesions in the early stages of NSF.
Cytoxan - A medication used to treat different types of cancer.
Thalidomide - Medication used to treat myeloma and leprosy. This drug causes severe birth defects and is part of a special distribution program regulated by the FDA. It can only be prescribed and dispensed by doctors and pharmacists who are registered with this program. Some NSF patients have shown improvement with this, but long-term side effects may be a problem.
Pentoxifylline - A vasodilator medication used to treat chronic occlusive arterial disease of the limbs. Is supposed to aid circulation. Has helped some NSF patients.
Plaquenil - Medication used to treat malaria, lupus, and arthritis. Has helped some NSF patients, but can cause side effects in the eyes and must be closely monitored.
Minocycline or similar antibiotics - Some NSF patients have shown improvement on this type of antibiotic, but gastrointestinal and other side effects may be a problem.
High dose intravenous Ig therapy - Immunoglobulin is administered through an IV. This is used to treat leukemia, HIV in children and several other diseases.
Physical therapy - Swimming and deep massage has been reported to help relieve some NSF symptoms and help slow the progression of joint problems.
Ultraviolet therapy - A medical therapy that uses ultraviolet electromagnetic radiation. It is used to treat diseases of the skin.
Renal transplantation - Some patients' NSF has improved following kidney transplant.
