title: Effects of pentoxifylline on inflammatory parameters in chronic kidney disease patients: a randomized trial.
abstract: BACKGROUND
  Pentoxifylline (PTF) is a potential therapeutic agent in chronic kidney disease due to its antiinflammatory and antiproteinuric effects that may influence the progression of renal disease.
  
  
  METHODS
  We conducted a prospective randomized trial of 91 patients with estimated glomerular filtration rate (eGFR) <60 ml/min, calculated with 4-variable Modification of Diet in Renal Disease (MDRD-4) Study equation. Patients were randomly assigned to treatment with PTF 400 mg (twice a day) (n=46) or to continue their usual therapy (n=45). Clinical, biochemical and inflammatory parameters were measured at baseline, and at 6 and 12 months of treatment. The objective of the study was to analyze the effect of PTF treatment on inflammatory markers and secondarily the effect on renal disease progression.
  
  
  RESULTS
  Baseline characteristics were similar in the 2 groups. High-sensitivity C-reactive protein (hs-CRP), serum fibrinogen and TNF-alpha decreased significantly in patients treated with PTF in comparison with the control group at 12 months (p=0.002, p=0.001 and p=0.000, respectively). Median urinary albumin excretion did not decrease with PTF treatment. In the PTF group, there was no significant change in eGFR after 12 months (from 42.3 ± 10.2 to 44.7 ± 11.3 ml/min per 1.73 m(2)), whereas in the control group there was a worsening by the end of the study (from 40.1 ± 12.4 to 35.7 ± 13.4 ml/min per 1.73 m(2)) (p=0.000 between groups).
  
  
  CONCLUSIONS
  PTF treatment decreases inflammatory markers in chronic kidney disease and stabilizes renal function.
authors.affiliation: Nephrology Unit, University Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.forename: Soledad
authors.initials: S
authors.lastname: García de Vinuesa
authors.forename: Borja
authors.initials: B
authors.lastname: Quiroga
authors.forename: Ursula
authors.initials: U
authors.lastname: Verdalles
authors.forename: Daniel
authors.initials: D
authors.lastname: Barraca
authors.forename: Claudia
authors.initials: C
authors.lastname: Yuste
authors.forename: Nayara
authors.initials: N
authors.lastname: Panizo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Verde
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Muñoz
authors.forename: José
authors.initials: J
authors.lastname: Luño
mesh_terms: D000419:Albuminuria / Q000188:drug therapy / Q000276:immunology; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D018450:Disease Progression; D005340:Fibrinogen / Q000378:metabolism; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D010431:Pentoxifylline / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; D005340:Fibrinogen; D002097:C-Reactive Protein; D010431:Pentoxifylline