A Randomized Clinical Trial of the Effect of Pentoxifylline on C-Reactive Protein Level and Dialysis Adequacy in End-stage Renal Disease Patients on Maintenance Hemodialysis.

INTRODUCTION:  C-reactive protein (CRP) is increased among patients on maintenance hemodialysis. Such inflammatory markers can result in protein-energy deficit syndromes and low adequacy of dialysis in these patients. This study evaluated the effect of pentoxifylline on serum CRP level and KT/V in end-stage renal disease patients on maintenance hemodialysis. MATERIAL AND METHODS: This 1-month randomized, double-blind, placebo-controlled clinical trial involving 73 patients with end-stage renal disease on maintenance hemodialysis assessed the effectiveness of 400 mg/d of pentoxifylline on serum CRP level decrease and improvement of dialysis adequacy. RESULTS: The difference in mean serum CRP levels of the pentoxifylline and placebo groups was not significant before study. While CRP showed showed a significant increase in the placebo group after completing the interventions (P = .01), the difference was nonsignificant in the pentoxifylline group (P = .53). The difference in the mean adequacy of dialysis was not significant before the interventions between the two groups, while there was a significant increase in the pentoxifylline group (P = .01) and a nonsignificant increase in the placebo group (P = .31) after the interventions. CONCLUSIONS: Among patients on maintenance hemodialysis, a 1-month trial of pentoxifylline was associated with a substantial improvement of adequacy of dialysis and a significant prevention from serum CRP level increase, but not a significant reduction in the mean serum CRP level.

Comparison of Serum LP-PLA2 Level and some Nutritional Factors between Well-Controlled and Poorly-Controlled Diabetic Patients.

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is produced by inflammatory cells, bound to LDL and other lipoproteins, and hydrolyzes oxidized phospholipids in LDL. Type 2 diabetes is the most common form of diabetes some investigations show the association of lipoprotein-associated phospholipase A2 mass and activity with the incidence of cardiovascular disease (CVD) in populations with high prevalences of insulin resistance and diabetes. This study is a cross-sectional descriptive and analytic study on 80 individuals with diabetes referring to the Tehran Diabetes Association. Patients divided into two groups (well-controlled and poorly controlled) based on their HbA1C. Personal information, anthropometric assessments (including height, weight, waist circumference and hip circumference) and semi-quantitative 147 items FFQ was used and vein blood samples were taken. After plasma separation, blood sample used for FBS, HbA1c and LP-PLA2 measurement. The independent sample T test was used for comparing means. Data analyses showed a significant difference between weight and WHR (waist to hip ratio) means in two studied groups, also there was a statistically significant difference in food intake (Energy, carbohydrate, protein, micronutrients percent and some of the micronutrients). FBS, HbA1C and LP-PLA2 means showed statistically significant difference (P<0/001) between two groups. This study showed LP-PLA2 is elevated in poorly-controlled patients compared to well-controlled diabetic patients, which may suggest some nutritional factors contributing to the regulation of this enzyme.