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Chronic hemodialysis may induce cutaneous symptoms in patients with AIP mimicking porphyria cutanea tarda (PCT).81 Since mainly ALA and PBG but not porphyrins have been filtered during dialysis, recurrent attacks were transformed to cutaneous manifestations in one patient.81 Use of high-flux hemodialysis and erythropoietin substitution might be of help since they remove plasma porphyrins and have alleviated clinical manifestation in PCT patients with end-stage renal failure.82,83 Kidney transplantation84 or combined liver and kidney transplantation85 have been done successfully and should be done whenever needed

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The connection between blood sugar, body weight, and reproductive hormones highlights the need for awareness of possible menstrual changes when using these medications