title: Effects of pentoxifylline on the haematologic status in anaemic patients with advanced renal failure.
abstract: OBJECTIVE
  Erythropoietin (EPO) deficiency is the main cause of renal anaemia. However, inhibition of erythropoiesis by cytokines such as tumour necrosis factor alpha (TNF-a) may play an important role. The aim of this work was to study the effects of pentoxifylline, an agent with anti-TNF-a properties, on the haematologic status in anaemic patients with advanced renal failure.
  
  
  METHODS
  In a prospective study, 7 anaemic patients with advanced renal disease (creatinine clearance <30 ml/min) were treated with pentoxifylline (400 mg orally daily) for 6 months. The evolution of haemoglobin, haematocrit, creatinine clearance and serum EPO and TNF-a a concentrations were compared with those obtained from an untreated control group.
  
  
  RESULTS
  Haemoglobin and haematocrit significantly increased in the pentoxifylline-treated patients (9.9+/-0.5 g/dl and 27.9+/-1.6% at baseline; 10.6+/-0.6 g/dl and 31.3+/-1.9% at the 6th month, respectively, p < 0.01), whereas no variation was seen in the control group. Serum EPO levels remained stable in all patients. However, the serum TNF-a concentration decreased significantly in patients receiving pentoxifylline (basal 623+/-366 pg/ml; 6th month 562+/-358 pg/ml, p < 0.01), but not in the control group.
  
  
  CONCLUSIONS
  Our findings suggest that the inhibition of erythropoiesis by cytokines may play a significant role in renal anaemia. The administration of agents with anti-cytokine properties, such as pentoxifylline, can improve the haematologic status in anaemic patients with advanced renal failure.
authors.affiliation: Department of Nephrology, Hospital Ntra. Sra. de Candelaria, Santa Cruz de Tenerife, Spain.
authors.forename: J F
authors.initials: JF
authors.lastname: Navarro
authors.forename: C
authors.initials: C
authors.lastname: Mora
authors.forename: J
authors.initials: J
authors.lastname: García
authors.forename: A
authors.initials: A
authors.lastname: Rivero
authors.forename: M
authors.initials: M
authors.lastname: Macía
authors.forename: E
authors.initials: E
authors.lastname: Gallego
authors.forename: M L
authors.initials: ML
authors.lastname: Méndez
authors.forename: J
authors.initials: J
authors.lastname: Chahin
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D003928:Diabetic Nephropathies / Q000150:complications; D004921:Erythropoietin / Q000172:deficiency; D005260:Female; D006401:Hematologic Agents / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D010431:Pentoxifylline / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D006401:Hematologic Agents; D014409:Tumor Necrosis Factor-alpha; D004921:Erythropoietin; D010431:Pentoxifylline