Effects of pentoxifylline on the haematologic status in anaemic patients with advanced renal failure.
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.
Navarro
J F
JF
Department of Nephrology, Hospital Ntra. Sra. de Candelaria, Santa Cruz de Tenerife, Spain.
Mora
C
C
García
J
J
Rivero
A
A
Macía
M
M
Gallego
E
E
Méndez
M L
ML
Chahin
J
J
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
D006401:Hematologic Agents; D014409:Tumor Necrosis Factor-alpha; D004921:Erythropoietin; D010431:Pentoxifylline