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Updated: Jul 2, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Progressive arm and leg stiffness in a patient with chronic renal impairment
Kichul Shin1, Scott R Granter, Jonathan S Coblyn
1Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA 02115, USA.
Background:
A 60-year-old white woman with a history of breast cancer, autoimmune hemolytic anemia, type 2 diabetes mellitus, peripheral vascular disease, and chronic renal insufficiency presented with stiffness in her arms and legs of 3 months' duration. She had undergone multiple MRI and magnetic resonance angiography examinations with gadolinium-containing contrast media over the last 2 years.
Investigations:
Complete physical examination including thorough skin examination; laboratory examinations including CBC, urinalysis, serum creatinine, protein electrophoresis and C-reactive protein; antinuclear antibody assay; Westergren erythrocyte sedimentation rate; and an excisional skin biopsy.
Diagnosis:
Nephrogenic systemic fibrosis (also known as nephrogenic fibrosing dermopathy).
Management:
Symptomatic treatment, physical therapy, and a brief trial of imatinib mesylate.
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