Effect of pentoxifylline in proteinuric chronic kidney disease: a systematic review and meta-analysis.
OBJECTIVE
The aim of this study was to assess the effect of pentoxifylline on proteinuria and renal function in chronic kidney disease (CKD) treatment.


METHODS
We systematically searched PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov for randomized and non-randomized controlled trials comparing pentoxifylline to placebo, no treatment or renin-angiotensin system blockade in proteinuric CKD patients. The outcomes concerning proteinuria, renal function, blood pressure and adverse events were extracted.


RESULTS
Twelve trials with 613 participants were identified. Pentoxifylline significantly decreased proteinuria [weighted mean difference (WMD) -0.60 g/day (95 % CI -0.84 to -0.36); p < 0.001] compared to placebo or no-treatment groups, but the decrease was not significant [WMD: 0.10 g/day (-0.34 to 0.54); p = 0.66] compared to captopril treatment. The decrease of glomerular filtration rate was significantly less [WMD: 3.67 ml/min (2.71-4.62); p < 0.001] in the pentoxifylline group than in the controls. There was no significant difference in serum creatinine [WMD: -0.03 mg/dl (-0.10 to 0.03); p = 0.28], diastolic blood pressure [WMD: 0.94 mmHg (-0.74 to 2.61); p = 0.27] and adverse events [RR: 0.89 (0.60 to 1.32); p = 0.56].


CONCLUSIONS
Pentoxifylline may decrease proteinuria and protect renal function in patients with CKD. Further studies are needed to confirm this result.
Department of Nephrology, Jining No. 1 People's Hospital, Jining, People's Republic of China.
Xiangpin
X
Jiang
Department of Nephrology, Jining No. 1 People's Hospital, Jining, People's Republic of China.
Shengguo
S
Zhou
The Blood Purification Center, Shandong Veterans General Hospital, Jinan, People's Republic of China.
Jing
J
Yao
Department of Nephrology, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China.
Xianglei
X
Kong
Department of Nephrology, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. qysncmy@163.com.
Meiyu
M
Cui
D016009:Chi-Square Distribution; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D016017:Odds Ratio; D010431:Pentoxifylline / Q000009:adverse effects / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011507:Proteinuria / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D012307:Risk Factors; D016896:Treatment Outcome; D064804:Urological Agents / Q000009:adverse effects / Q000627:therapeutic use*
D010726:Phosphodiesterase Inhibitors; D064804:Urological Agents; D010431:Pentoxifylline
Chronic kidney disease; Glomerular filtration rate; Meta-analysis; Pentoxifylline; Proteinuria