The Effect of Pentoxifylline Treatment on Diabetic Nephropathy Progression

AbstractObjective: Diabetic nephropathy (DN) is an important cause of end stage renal disease. It has been suggested that pentoxifylline, which is used for the treatment of vascular diseases, has anti-inflammatory properties and may have positive effects on diabetic nephropathy. In this study, we aimed to investigate the effect of pentoxifylline treatment on renal functions and proteinuria levels in patients with DN.Material and Methods: Thirty-six DN patients treated with 1200 mg/day pentoxifylline were screened retrospectively. Twenty-four-hour proteinuria and estimated glomerular filtration rate (eGFR) values were recorded at 3rd and 6th months before starting treatment and at 3rd, 6th and 12th months of pentoxifylline treatment.Results: The average age was 51.9±12.3 years. In this patient cohort, 12 were male and 16 were using angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB). Twenty-three patients used pentoxifylline for less than 6 months (group A) and 13 patients used it for more than 6 months (group B). There was no difference between groups A and B regarding the amount of 24-hour proteinuria (Group A: 3.76±2.49 g/day, Group B: 4.72±3.20 g/day, p=0.423) and loss of eGFR (Group A: 37.98±31.2 ml/min, Group B: 34.00±29.99 ml/min, p=0.846).Conclusion: In this study, the effect of pentoxifylline on proteinuria and eGFR loss was not observed in patients with diabetic nephropathy during 1-year follow-up. ÖzetAmaç: Diabetik nefropati (DN) son dönem böbrek yetersizliğinin önemli bir nedenidir. Vasküler hastalıklarda kullanılan ve anti-inflamatuar özellikleri olan pentoksifilinin diyabetik nefropatide olumlu etkileri olabileceği öne sürülmüştür. Bu çalışmada DN nedeni ile takipte olan ve pentoksifilin kullanan hastaların tedavi öncesi ve sonrası dönemdeki böbrek fonksiyonları ve proteinürileri değerlendirilmiştir. Gereç ve Yöntemler: Kliniğimizde takipte olup pentoksifilin (1200 mg/gün) tedavisi alan 36 diabetik nefropati hastası retrospektif olarak tarandı. Tedavi başlanmadan önceki 3. ve 6. ay; pentoksifilin tedavisinin 3., 6., 9. ve 12. aylardaki günlük proteinüri miktarı ve eGFR (estimated glomerular filtration rate, tahmini glomerüler filtrasyon hızı) değerleri kayıt edildi.Bulgular: Çalışmaya alınan 36 hastanın ortalama yaşı 51.9±12.3 yıl, 12’si erkek ve 16’sı Anjiotensin dönüştürücü enzim (Angiotensin converting enzyme inhibitor, ACEİ) ya da Anjiotensin reseptör blokeri (Angiotensin receptor blocker, ARB) kullanıyor