Effects of pentoxifylline on inflammatory parameters in chronic kidney disease patients: a randomized trial

J Nephrol. 2012 Nov-Dec;25(6):969-75. doi: 10.5301/jn.5000077.

Abstract

Background: Pentoxifylline (PTF) is a potential therapeutic agent in chronic kidney disease due to its antiinflammatory and antiproteinuric effects that may influence the progression of renal disease.

Subjects and methods: We conducted a prospective randomized trial of 91 patients with estimated glomerular filtration rate (eGFR) <60 ml/min, calculated with 4-variable Modification of Diet in Renal Disease (MDRD-4) Study equation. Patients were randomly assigned to treatment with PTF 400 mg (twice a day) (n=46) or to continue their usual therapy (n=45). Clinical, biochemical and inflammatory parameters were measured at baseline, and at 6 and 12 months of treatment. The objective of the study was to analyze the effect of PTF treatment on inflammatory markers and secondarily the effect on renal disease progression.

Results: Baseline characteristics were similar in the 2 groups. High-sensitivity C-reactive protein (hs-CRP), serum fibrinogen and TNF-alpha decreased significantly in patients treated with PTF in comparison with the control group at 12 months (p=0.002, p=0.001 and p=0.000, respectively). Median urinary albumin excretion did not decrease with PTF treatment. In the PTF group, there was no significant change in eGFR after 12 months (from 42.3 ± 10.2 to 44.7 ± 11.3 ml/min per 1.73 m(2)), whereas in the control group there was a worsening by the end of the study (from 40.1 ± 12.4 to 35.7 ± 13.4 ml/min per 1.73 m(2)) (p=0.000 between groups).

Conclusions: PTF treatment decreases inflammatory markers in chronic kidney disease and stabilizes renal function.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Albuminuria / drug therapy
  • Albuminuria / immunology
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Chi-Square Distribution
  • Disease Progression
  • Fibrinogen / metabolism
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Inflammation Mediators / blood*
  • Pentoxifylline / adverse effects
  • Pentoxifylline / therapeutic use*
  • Prospective Studies
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / immunology
  • Renal Insufficiency, Chronic / physiopathology
  • Spain
  • Time Factors
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Anti-Inflammatory Agents
  • Biomarkers
  • Inflammation Mediators
  • Tumor Necrosis Factor-alpha
  • Fibrinogen
  • C-Reactive Protein
  • Pentoxifylline