Additive antiproteinuric effect of pentoxifylline in patients with diabetic nephropathy under angiotensin receptor blockade: A short-term, randomized, and controlled trial

Background: The ever-increasing prevalence of diabetes has led to a higher incidence of progression into complications including nephropathy. Diabetic kidney disease (DKD) is a chronic condition that is managed with renin-angiotensin-aldosterone system blockers which retard its progression. Pentoxifylline as an add-on therapy has been tried for reducing DKD. Aims and Objectives: The aims of this study were to study the safety and efficacy of pentoxifylline added on to an angiotensin II receptor blocker (ARB) to reduce the progression of the disease condition in diabetic nephropathy (DN) patients over 1 year. Materials and Methods: It is a randomized open-label study conducted in the Department of Nephrology, of a tertiary care center for 1 year. Type 2 diabetes patients with DN who satisfied the eligibility criteria were randomized into pentoxifylline added on to ARB or ARB alone and followed up for urine albumin-creatinine ratio (ACR) and serum tumor necrosis factor (TNF)-alpha. Results: Twenty-six patients were recruited and completed the study. Urine ACR was significantly low in the pentoxifylline group compared to the ARB alone group (P = 0.021). Serum TNF-? was decreased in the pentoxifylline group in comparison to the ARB alone group (P = 0.06). Conclusion: Pentoxifylline caused significant lowering of urinary ACR and urine TNF-? for 4 months.