title: Evaluation of the effect of pentoxifylline on erythropoietin-resistant anemia in hemodialysis patients.
abstract: Use of recombinant human erythropoietin (rh-Epo) improves hemoglobin (Hgb) in 90-95% of the cases of anemia of chronic kidney disease (CKD). However, it is known that pro-inflammatory cytokines such as interferon-gamma (IFN-γ), tumor necrosis factor-alfa (TNF-α) and interleukin-1 (IL-1) suppress erythropoiesis, resulting in inadequate response to rh-Epo. Pentoxifylline has been shown to have modulatory effects on the immune system. This prospective study to evaluate the effect of pentoxyphylline on erythropoeisis was performed on 15 (eight males, seven females) clinically stable patients who had been on hemodialysis for at least six months with anemia (Hgb of <10.7 g/dL) unresponsive to rh-Epo despite high doses. They were treated with 400 mg pentoxifylline tablets once daily for 12 weeks. Hgb increased after one and two months of drug administration, but significant changes were observed in eight (53%) patients after three months (P <0.05). Our study illustrates a probable new use for an old medicine. Three months treatment with pentoxifylline was seen to increase Hgb significantly in rh-Epo-resistant patients. More prospective studies with a larger sample size are needed to determine the inhibitory role of cytokines on hematopoiesis and exploring new drugs or new drug indications to overcome anemia in advanced renal failure.
authors.forename: Amir-Hooshang
authors.initials: AH
authors.lastname: Mohammadpour
authors.affiliation: Nephrology Ward, Department of Internal Medicine, Imam-Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nazemian
authors.forename: Mohammad Hassanzade
authors.initials: MH
authors.lastname: Khaiat
authors.forename: Mohsen
authors.initials: M
authors.lastname: Tafaghodi
authors.forename: Pooneh
authors.initials: P
authors.lastname: Salari
authors.forename: Somaieh
authors.initials: S
authors.lastname: Charkazi
authors.forename: Masih
authors.initials: M
authors.lastname: Naghibi
authors.forename: Jamal
authors.initials: J
authors.lastname: Shamsara
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D004351:Drug Resistance; D057915:Drug Substitution; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007492:Iran; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010431:Pentoxifylline / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis / Q000009:adverse effects; D013997:Time Factors; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha; D004921:Erythropoietin; D010431:Pentoxifylline