Pentoxifylline Decreases Dialysis Risk in Patients With Advanced Chronic Kidney Disease

P-C Wu; C-J Wu; C-J Lin; C-F Pan; C-Y Chen; T-M Huang; C-H Wu; S-L Lin; Y-M Chen; L Chen; V-C Wu; NSARF Group; Kidney Consortium

doi:10.1002/cpt.173

Pentoxifylline Decreases Dialysis Risk in Patients With Advanced Chronic Kidney Disease

Clin Pharmacol Ther. 2015 Oct;98(4):442-9. doi: 10.1002/cpt.173. Epub 2015 Jul 14.

Authors

P-C Wu^{1

2}, C-J Wu^{1

3

4}, C-J Lin^{1

3

5}, C-F Pan¹, C-Y Chen¹, T-M Huang⁶, C-H Wu⁷, S-L Lin⁸, Y-M Chen⁸, L Chen⁹, V-C Wu⁸; NSARF Group; Kidney Consortium

Affiliations

¹ Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
² Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Department of Medicine, Mackay Medical College, Taipei, Taiwan.
⁴ Graduate Institute of Medical Sciences and Department of Pharmacology, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁵ Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
⁶ Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou City, Yunlin County, Taiwan.
⁷ Division of Nephrology, Taipei Buddhist Tzu Chi General Hospital, Buddhist Tzu Chi University, Taipei, Taiwan.
⁸ Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁹ Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.

PMID: 26082272
DOI: 10.1002/cpt.173

Abstract

Few studies evaluated the effects of pentoxifylline on hard endpoints in patients with predialysis stage 5 chronic kidney disease (CKD). Thus, we tried to explore the effects of pentoxifylline and its interaction with renin-angiotensin-aldosterone system (RAAS) blockade on the development of endstage renal disease (ESRD) and mortality. This nationwide cohort study retrospectively included patients who had a serum creatinine level of >6 mg/dL and received erythropoiesis-stimulating agents (ESAs) between 2000 and 2010. We analyzed 7,366 pentoxifylline users and 7,366 propensity score-matched nonusers. Using Cox proportional hazard models, pentoxifylline reduced the risks of ESRD and the composite renal outcome but not that of mortality. In terms of the risks of developing ESRD, pentoxifylline alone exerted a comparable beneficial effect to combined therapy with an RAAS inhibitor and greater renoprotection than RAAS inhibitor monotherapy. This study suggests pentoxifylline is efficacious in slowing progression to ESRD in patients with predialysis stage 5 CKD.

Publication types

Comparative Study

MeSH terms

Aged
Angiotensin II Type 1 Receptor Blockers / adverse effects
Angiotensin II Type 1 Receptor Blockers / therapeutic use*
Angiotensin-Converting Enzyme Inhibitors / adverse effects
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Biomarkers / blood
Chi-Square Distribution
Creatinine / blood
Disease Progression
Drug Therapy, Combination
Female
Humans
Kidney Failure, Chronic / diagnosis
Kidney Failure, Chronic / mortality
Kidney Failure, Chronic / prevention & control*
Logistic Models
Male
Middle Aged
Multivariate Analysis
Pentoxifylline / adverse effects
Pentoxifylline / therapeutic use*
Propensity Score
Proportional Hazards Models
Renal Dialysis*
Renal Insufficiency, Chronic / diagnosis
Renal Insufficiency, Chronic / drug therapy*
Renal Insufficiency, Chronic / mortality
Renal Insufficiency, Chronic / physiopathology
Renin-Angiotensin System / drug effects*
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Urological Agents / adverse effects
Urological Agents / therapeutic use*

Substances

Angiotensin II Type 1 Receptor Blockers
Angiotensin-Converting Enzyme Inhibitors
Biomarkers
Urological Agents
Creatinine
Pentoxifylline