Pentoxifylline in the treatment of refractory nephrotic syndrome secondary to lupus nephritis.
OBJECTIVE
To evaluate the efficacy of pentoxifylline in the treatment of refractory nephrotic syndrome secondary to lupus nephritis.


METHODS
We studied 11 patients who met the following inclusion criteria: (1) systemic lupus erythematosus (SLE) according to the American College of Rheumatology criteria; (2) lupus nephritis class III, IV, or V according to the World Health Organization; (3) proteinuria in the nephrotic range (> or = 3 g/24 h) for at least 6 months despite treatment. All patients received pentoxifylline 800-1600 mg/day. Clinical and laboratory data, including creatinine, urine test, creatinine clearance, and 24-h urinary protein, were collected monthly for 6 months. No changes in treatment were allowed, except for alterations in the dose of prednisone.


RESULTS
All patients had received corticosteroids and immunosuppressants for at least 6 months. All patients showed a decrease in proteinuria concentrations after use of pentoxifylline from a median of 5.5 to 2.0 (p = 0.003). No patient discontinued the drug due to side effects. One patient had nausea and one had anxiety that disappeared after decreasing the dosage.


CONCLUSIONS
Pentoxifylline seems to be effective in the treatment of refractory nephrotic syndrome secondary to lupus nephritis.
Galindo-Rodríguez
Griselda
G
Rheumatic Disease Unit, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Seris y Zaachila SN, Col. La Raza, Mexico City, Mexico 02990.
Bustamante
Reyna
R
Esquivel-Nava
Gerardo
G
Salazar-Exaire
Daniel
D
Vela-Ojeda
Jorge
J
Vadillo-Buenfil
Manuel
M
Aviña-Zubieta
J Antonio
JA
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008181:Lupus Nephritis / Q000150:complications*; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy* / Q000209:etiology* / Q000652:urine; D010431:Pentoxifylline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011241:Prednisone / Q000008:administration & dosage; D011507:Proteinuria / Q000209:etiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D003520:Cyclophosphamide; D010431:Pentoxifylline; D011241:Prednisone