The renoprotective potential of pentoxifylline in chronic kidney disease.
Current interventions with proven efficacy, such as glycemic and blood pressure control, dietary protein restriction, and angiotensin II blockade, slow the progression of chronic kidney disease (CKD); however, whether long-term cessation of CKD progression is possible remains unclear. Because of the pathogenetic complexity of this condition, multidrug interventions with the least adverse effects should be investigated as the next step in attempts to stop CKD progression. Pentoxifylline, a non-selective phosphodiesterase inhibitor with indiscernible toxicity, exerts potent inhibitory effects against cell proliferation, inflammation, and extracellular matrix accumulation, all of which play important roles in CKD progression. Pentoxifylline monotherapy markedly reduces proteinuria in patients with membranous nephropathy. Moreover, limited human studies have proven pentoxifylline efficacy in reducing proteinuria in patients with diabetes receiving angiotensin-converting enzyme inhibitors, and in patients with nephrotic syndrome secondary to lupus nephritis despite immunosuppressive therapy. Further clinical trials are necessary to examine whether pentoxifylline can improve renal outcomes in patients receiving interventions of proven efficacy.
Lin
Shuei-Liong
SL
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.
Chiang
Wen-Chih
WC
Chen
Yung-Ming
YM
Lai
Chun-Fu
CF
Tsai
Tun-Jun
TJ
Hsieh
Bor-Shen
BS
D049109:Cell Proliferation / Q000187:drug effects; D003928:Diabetic Nephropathies / Q000188:drug therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D010431:Pentoxifylline / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D011507:Proteinuria / Q000517:prevention & control
D010726:Phosphodiesterase Inhibitors; D010431:Pentoxifylline