Phenotypes of Mineral Bone Disorder in Chronic Kidney Disease in a Dialysis Population.

BACKGROUND: Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is associated with clinical outcomes. It is necessary to identify the phenotype to make clinical decisions that optimize resources and follow-up. OBJECTIVE: To determine the frequency of the CKD-MBD phenotype in dialysis patients and the associated factors. METHODS: Cross-sectional study in 440 patients, evaluated for CKD-MBD. Phenotypes show frequency of high, low or on target levels of PTH, vitamin D and phosphorus. The most common phenotype was used for comparisons. RESULTS: Age was 37.5 ± 15.8 years, 53% male, 28% were diabetic, 60% on peritoneal dialysis (PD), dialysis vintage was 12.0 months (IQR 3.0-34.3). High PTH was 58%, low vitamin D 82%, high phosphorus 39%, low calcium 50%, and vascular calcification 55%. The combination of high PTH and low vitamin D and high on-target phosphorus was 39%. Those with high PTH and low vitamin D were more likely to use PD (71 vs 51%; p <0.0001), had higher lipids: total cholesterol (159 vs. 152; p = 0.002) and triglycerides (137 vs. 123; p = 0.02), higher potassium (4.7 ± 0.7 vs. 4.9 ± 0.9 mg/dL; p = 0.04), and higher serum creatinine (11.9 ± 4.4 vs. 10.6 ± 3.7 mg/dL; p = 0.01). Predictors of the most common phenotypes were PD use, total cholesterol, and serum creatinine. CONCLUSIONS: More than one third (38%) of our sample of patients had high PTH and low vitamin D with either high or normal phosphorus. Patients with these phenotypes more frequently used PD, had higher lipids and low potassium. PD use, total cholesterol and serum creatinine were significantly associated with these phenotypes.

The Inflammatory and Oxidative Status of Newly Diagnosed Class III and Class IV Lupus Nephritis, with Six-Month Follow-Up.

Lupus nephritis (LN) is the most frequent and severe complication of systemic lupus erythematosus (SLE). A prospective cohort with a six-month follow-up was performed. Twelve SLE patients diagnosed with LN Class III, twelve NL Class IV patients, and twelve healthy control subjects (HC) were included. SLE data, renal function, oxidants, antioxidants, and inflammation were determined at baseline and six-month follow-up. During the six-month follow-up, the SLE Disease Activity Index (SLEDAI-2K) decreased in both LN Class III (20.08 ± 6.92 vs. 11.92 ± 5.87, p < 0.001) and LN Class IV (25.33 ± 6.01 vs. 13.83 ± 5.52, p < 0.001) patients. Furthermore, the values of the C4 component also increased during follow-up for LN Class III (25.36 ± 6.34 vs. 30.91 ± 9.22, p = 0.027) and LN Class IV (12.18 ± 3.90 vs. 20.33 ± 8.95, p = 0.008) groups. Regarding inflammation markers, both groups presented decreased C-reactive protein (CRP), but this was only significant for patients with LN class III (7.93 ± 1.77 vs. 4.72 ± 3.23, p = 0.006). Renal function remained stable in both groups, with no changes in eGFR. Patients with LN Class III and Class IV showed higher baseline levels for lipoperoxides (Class III p < 0.01, Class IV p < 0.1) and carbonyl groups in proteins (Class III p < 0.01, Class IV p < 0.1) compared to HC. Moreover, both groups presented lower baseline values of total antioxidant capacity (Class III p < 0.01, Class IV p < 0.1) and catalase (Class III p < 0.01, Class IV p < 0.1) compared to HCs. However, antioxidant and oxidant markers did not show significant differences between baseline values and at six months for either of the two study groups. In conclusion, patients show an imbalance in the oxidative state characterized by the increase in the oxidants LPO and protein carbonyl groups and the decrease in the activity of the antioxidant enzymes TAC and CAT compared to HC. However, the patients did not present an increase in disease activity and renal function improvement. The glomerular filtration rate did not change during the length of the study, and SLEDAI -2K, C3, and C4 improved. The early co-management between Rheumatologists and Nephrologists is essential to prevent the rapid progression of LN. It would be interesting to administer antioxidant supplements to patients with a recent diagnosis of LN and evaluate its effect in a follow-up study.

Clinical impact using low-dose mycophenolate mofetil with tacrolimus on infectious, noninfectious complications and acute rejection, in renal transplant: A single hospital experience in Mexico.

Evidence supporting a starting dose of 2 g/day of mycophenolate mofetil (MMF) in combination with tacrolimus (TAC) for renal transplantation (RT) is still limited, but maintaining a dose of <2 g could result in worse clinical outcomes in terms of acute rejection (AR). This study aimed to determine the association between AR and infectious and noninfectious complications after RT with a dose of 1.5 g vs 2 g of MMF. A prospective cohort study was performed with a 12-month follow-up of recipients of RT from living donors with low (1.5 g/day) or standard (2 g/day) doses of MMF. The association between adverse effects and complications and doses of MMF was examined using Cox proportional hazard models, and survival free of AR, infectious diseases, and noninfectious complications was evaluated using the Kaplan-Meier test. At the end of the follow-up, the incidence of infectious diseases was 52% versus 50% (P = .71) and AR was 5% versus 5% (P = .86), respectively. The survival rate free of gastrointestinal (GI) complications requiring medical attention was higher in the low-dose group than in the standard-dose dose (88% vs 45%, respectively; P < .001). The use of 1.5 g/day of MMF confers a reduction in GI complications without an increase in infectious diseases or the risk of AR.

Mycetoma by Actinomadura madurae in the central nervous system: Renal transplant receptor disease.

The mycetoma is a granulomatous chronic disease, subcutaneous disease is the common presentation, very few cases are reported affecting central nervous system, but there are not cases in Renal Transplant (RT).

Towards a Resilience to Stress Index Based on Physiological Response: A Machine Learning Approach.

This study proposes a new index to measure the resilience of an individual to stress, based on the changes of specific physiological variables. These variables include electromyography, which is the muscle response, blood volume pulse, breathing rate, peripheral temperature, and skin conductance. We measured the data with a biofeedback device from 71 individuals subjected to a 10-min psychophysiological stress test. The data exploration revealed that features' variability among test phases could be observed in a two-dimensional space with Principal Components Analysis (PCA). In this work, we demonstrate that the values of each feature within a phase are well organized in clusters. The new index we propose, Resilience to Stress Index (RSI), is based on this observation. To compute the index, we used non-supervised machine learning methods to calculate the inter-cluster distances, specifically using the following four methods: Euclidean Distance of PCA, Mahalanobis Distance, Cluster Validity Index Distance, and Euclidean Distance of Kernel PCA. While there was no statistically significant difference (p>0.01) among the methods, we recommend using Mahalanobis, since this method provides higher monotonic association with the Resilience in Mexicans (RESI-M) scale. Results are encouraging since we demonstrated that the computation of a reliable RSI is possible. To validate the new index, we undertook two tasks: a comparison of the RSI against the RESI-M, and a Spearman correlation between phases one and five to determine if the behavior is resilient or not. The computation of the RSI of an individual has a broader scope in mind, and it is to understand and to support mental health. The benefits of having a metric that measures resilience to stress are multiple; for instance, to the extent that individuals can track their resilience to stress, they can improve their everyday life.

Impact of transplantation on neutrophil extracellular trap formation in patients with end-stage renal disease: A single-center, prospective cohort study.

ABSTRACT: Increased neutrophil extracellular trap (NET) formation associates with high cardiovascular risk and mortality in patients with end-stage renal disease (ESRD). However, the effect of transplantation on NETs and its associated markers remains unclear. This study aimed to characterize circulating citrullinated Histone H3 (H3cit) and Peptidyl Arginase Deiminase 4 (PAD4) in ESRD patients undergoing transplantation and evaluate the ability of their neutrophils to release NETs.This prospective cohort study included 80 healthy donors and 105 ESRD patients, out of which 95 received a transplant. H3cit and PAD4 circulating concentration was determined by enzyme-linked immunosorbent assay in healthy donors and ESRD patients at the time of enrollment. An additional measurement was carried out within the first 6 months after transplant surgery. In vitro NET formation assays were performed in neutrophils isolated from healthy donors, ESRD patients, and transplant recipients.H3cit and PAD4 levels were significantly higher in ESRD patients (H3cit, 14.38 ng/mL [5.78-27.13]; PAD4, 3.22 ng/mL [1.21-6.82]) than healthy donors (H3cit, 6.45 ng/mL [3.30-11.65], P < .0001; PAD4, 2.0 ng/mL [0.90-3.18], P = .0076). H3cit, but not PAD4, increased after transplantation, with 44.2% of post-transplant patients exhibiting high levels (≥ 27.1 ng/mL). In contrast, NET release triggered by phorbol 12-myristate 13-acetate was higher in neutrophils from ESRD patients (70.0% [52.7-94.6]) than healthy donors (32.2% [24.9-54.9], P < .001) and transplant recipients (19.5% [3.5-65.7], P < .05).The restoration of renal function due to transplantation could not reduce circulating levels of H3cit and PAD4 in ESRD patients. Furthermore, circulating H3cit levels were significantly increased after transplantation. Neutrophils from transplant recipients exhibit a reduced ability to form NETs.

Cytomegalovirus in renal transplant recipients from living donors with and without valganciclovir prophylaxis and with immunosuppression based on anti-thymocyte globulin or basiliximab.

BACKGROUND: In our population, anti-thymocyte globulin (ATG) of 1 mg/Kg/day for 4 days is used; which permits not using valgancyclovir (VGC) prophylaxis in some renal transplant recipients (RTR) with moderate risk (R+), to reduce costs. This study aimed to determine the incidence and risk of developing cytomegalovirus (CMV), with or without prophylaxis, when exposed to low doses of ATG or basiliximab (BSL). PATIENTS AND METHODS: A retrospective cohort included 265 RTR with follow-up of 12 months. Prophylaxis was used in R-/D+ and some R+. Tacrolimus (TAC), mycophenolate mofetil, and prednisone were used in all patients. Logistic regression analysis was performed to estimate the risk of CMV in RTR with or without VGC. RESULTS: Cytomegalovirus was documented in 46 (17.3%) patients: 20 (43.5%) with CMV infection, and 26 (56.5%) with CMV disease. Anti-thymocyte globulin was used in 39 patients (85%): 32 R+, six D+/R-, and one D-/R-. ATG was used in 90% (27 of 30) of patients with CMV and without prophylaxis. The multivariate analysis showed an association of risk for CMV with the absence of prophylaxis (RR 2.29; 95% CI 1.08-4.86), ATG use (RR 3.7; 95% CI 1.50-9.13), TAC toxicity (RR 3.77; 95% CI 1.41-10.13), and lymphocytes at the sixth post-transplant month (RR 1.77; 95% CI 1.0-3.16). CONCLUSIONS: Low doses of ATG favored the development of CMV and a lower survival free of CMV compared with BSL. In scenarios where resources for employing VGC are limited, BSL could be an acceptable strategy.

Donor-specific antibodies development in renal living-donor receptors: Effect of a single cohort.

Minimization in immunosuppression could contribute to the appearance the donor-specific HLA antibodies (DSA) and graft failure. The objective was to compare the incidence of DSA in renal transplantation (RT) in recipients with immunosuppression with and without steroids. A prospective cohort from March 1st, 2013 to March 1st, 2014 and follow-up (1 year), ended in March 2015, was performed in living donor renal transplant (LDRT) recipients with immunosuppression and early steroid withdrawal (ESW) and compared with a control cohort (CC) of patients with steroid-sustained immunosuppression. All patients were negative cross-matched and for DSA pre-transplant. The regression model was used to associate the development of DSA antibodies and acute rejection (AR) in subjects with immunosuppressive regimens with and without steroids. Seventy-seven patients were included (30 ESW and 47 CC). The positivity of DSA class I (13% vs 2%; P < 0.05) and class II (17% vs 4%, P = 0.06) antibodies were higher in ESW versus CC. The ESW tended to predict DSA class II (RR 5.7; CI (0.93-34.5, P = 0.06). T-cell mediated rejection presented in 80% of patients with DSA class I (P = 0.07), and 86% with DSA II (P = 0.03), and was associated with DSA class II, (RR 7.23; CI (1.2-44), P = 0.03). ESW could favor the positivity of DSA. A most strictly monitoring the DSA is necessary for the early stages of the transplant to clarify the relationship between T-cell mediated rejection and DSA.

Urinary expression of long non-coding RNA TUG1 in non-diabetic patients with glomerulonephritides.

Metabolic alterations serve a significant role in the pathogenesis of kidney disease. Long non-coding RNA (lncRNA) taurine upregulated gene 1 (TUG1) is a known regulator of podocyte health and mitochondrial biogenesis. Although TUG1 protects against podocyte loss in models of diabetic nephropathy, it is unknown if urinary TUG1 expression is associated with clinical and histopathological findings in non-diabetic patients diagnosed with glomerulonephritides. In the present study, the expression of TUG1, podocyte-specific markers (nephrin and podocin) and mitochondrial biogenesis-associated mRNAs (transcription factor A mitochondrial, cytochrome C oxidase subunit 5A and peroxisome proliferator-activated receptor γ coactivator 1α) were examined in urinary sediment of non-diabetic patients with biopsy-confirmed glomerulonephritides and healthy controls. Urinary expression of TUG1 was significantly lower in patients with glomerulonephritides, particularly those diagnosed with Focal Segmental Glomerulosclerosis (FSGS). Furthermore, TUG1 levels were associated with urinary expression of podocyte-specific markers and mRNAs associated with mitochondrial biogenesis. Loss of TUG1 expression in urinary sediment was strongly associated with FSGS, highlighting the potential of this lncRNA and its mitochondrial biogenesis-associated targets as non-invasive biomarkers of assessing podocytopathy.

A Review of Supervised Classification based on Contrast Patterns: Applications, Trends, and Challenges.

Supervised classification based on Contrast Patterns (CP) is a trending topic in the pattern recognition literature, partly because it contains an important family of both understandable and accurate classifiers. In this paper, we survey 105 articles and provide an in-depth review of CP-based supervised classification and its applications. Based on our review, we present a taxonomy of the existing application domains of CP-based supervised classification, and a scientometric study. We also discuss potential future research opportunities.

A Pattern-Based Approach for Detecting Pneumatic Failures on Temporary Immersion Bioreactors.

Temporary Immersion Bioreactors (TIBs) are used for increasing plant quality and plant multiplication rates. These TIBs are actioned by mean of a pneumatic system. A failure in the pneumatic system could produce severe damages into the TIB. Consequently, the whole biological process would be aborted, increasing the production cost. Therefore, an important task is to detect failures on a temporary immersion bioreactor system. In this paper, we propose to approach this task using a contrast pattern based classifier. We show that our proposal, for detecting pneumatic failures in a TIB, outperforms other approaches reported in the literature. In addition, we introduce a feature representation based on the differences among feature values. Additionally, we collected a new pineapple micropropagation database for detecting four new types of pneumatic failures on TIBs. Finally, we provide an analysis of our experimental results together with experts in both biotechnology and pneumatic devices.

Ensemble of One-Class Classifiers for Personal Risk Detection Based on Wearable Sensor Data.

This study introduces the One-Class K-means with Randomly-projected features Algorithm (OCKRA). OCKRA is an ensemble of one-class classifiers built over multiple projections of a dataset according to random feature subsets. Algorithms found in the literature spread over a wide range of applications where ensembles of one-class classifiers have been satisfactorily applied; however, none is oriented to the area under our study: personal risk detection. OCKRA has been designed with the aim of improving the detection performance in the problem posed by the Personal RIsk DEtection(PRIDE) dataset. PRIDE was built based on 23 test subjects, where the data for each user were captured using a set of sensors embedded in a wearable band. The performance of OCKRA was compared against support vector machine and three versions of the Parzen window classifier. On average, experimental results show that OCKRA outperformed the other classifiers for at least 0.53% of the area under the curve (AUC). In addition, OCKRA achieved an AUC above 90% for more than 57% of the users.

Retiro temprano de esteroides en una cohorte de trasplante renal tratada con tacrolimus, mofetil micofenolato y basiliximab / Early steroid withdrawal in a renal transplant cohort treated with tacrolimus, mycophenolate mofetil and basiliximab

Antecedentes: No hay suficiente evidencia sobre la frecuencia de rechazo agudo y la función del injerto en los pacientes con retiro temprano de esteroides (RTE). El objetivo del presente estudio es comparar el efecto del RTE sobre la tasa de filtrado glomerular (TFG), la supervivencia/rechazo del injerto en receptores de una cohorte de tratados con tacrolimus/mofetil micofenolato, comparada con un grupo control. Material y métodos: Cohorte retrospectiva en 60 receptores de bajo riesgo inmunológico entre diciembre de 2005 y julio de 2010. Cohorte del estudio (C-RTE; N = 32), el RTE se hizo el 5o día mientras recibían tacrolimus/mofetil micofenolato. La cohorte control (C-C, N = 28) recibió prednisona/tacrolimus/mofetil micofenolato. Las variables clínicas, bioquímicas e histológicas fueron evaluadas al inicio del estudio, y a los 3, 6 y 12 meses de seguimiento. Se utilizó Kaplan-Meier y el modelo de riesgos proporcionales de Cox para evaluar la supervivencia. Las comparaciones entre cohortes fueron hechas por la t de Student y χ2. Resultados: Durante el seguimiento, la C-C muestra presión sanguínea significativamente mayor tanto sistólica (125 ± 10 frente a 114 ± 8) como diastólica (81 ± 8 frente a 72 ± 7), glucosa sérica (96 ± 13 frente a 86 ± 10), triglicéridos (177 ± 61 frente a 129 ± 34), colesterol total (183 ± 43 frente a 148 ± 34) y colesterol LDL (100 ± 22 frente a 87 ± 25). La C-C presentó una mayor proporción de uso de antihipertensivos (57 frente a 13 %) y de estatinas (27 frente a 9 %). La TFGe fue mejor en la C-RTE que en la C-C (85,4 ± 20,6 frente a 70,6 ± 17,0, p = 0,004). La frecuencia de rechazo agudo fue menor en la C-RTE. Conclusiones: La supervivencia del injerto, la TFG, la tasa de rechazo agudo y el perfil metabólico fueron mejores en la C-RTE que en la C-C (AU)

Background: Acute rejection and graft function have not been completely clarified in early-steroid-withdrawal (ESW) patients. The objective of this study was to compare the effect of early steroid withdrawal on GFR, graft survival/rejection in recipients in a cohort treated with tacrolimus/mycophenolate mofetil compared to a control cohort. Material and method: Retrospective cohort, in 60 low immunological risk recipients between December 2005 and July 2010. Study cohort (ESW-C N=32), steroid withdrawal was carried out after 5 days, while they were receiving tacrolimus/mycophenolate mofetil. The control cohort (C-C, N=28) received prednisone/tacrolimus/mycophenolate mofetil. Clinical, biochemical and histological variables were assessed at baseline and after 3, 6, and 12 months of follow-up. Kaplan-Meier and the Cox proportional hazards model were used to assess survival. Comparisons between cohorts were carried out by the Student's t and χ2 tests. Results: At follow-up, C-C displayed significantly higher systolic (125±10 vs. 114±8) and diastolic (81±8 vs. 72±7) blood pressure, serum glucose (96±13 vs. 86±10), triglycerides (177±61 vs. 129±34), total (183±43 vs. 148±34) and LDL-cholesterol (100±22 vs. 87±25). C-C had a higher proportion of antihypertensive (57 vs. 13%), and statins (27 vs. 9%) use. eGFR was better in ESW-C than in C-C (85.4±20.6 vs. 70.6±17.0, p=.004). AR frequency was lower in ESW-C. Conclusions: Graft survival, GFR, AR rate and metabolic profile were better in the ESW-C than in C-C (AU)

Early steroid withdrawal in a renal transplant cohort treated with tacrolimus, mycophenolate mofetil and basiliximab.

BACKGROUND: Acute rejection and graft function have not been completely clarified in early-steroid-withdrawal (ESW) patients. The objective of this study was to compare the effect of early steroid withdrawal on GFR, graft survival/rejection in recipients in a cohort treated with tacrolimus/mycophenolate mofetil compared to a control cohort. MATERIAL AND METHOD: Retrospective cohort, in 60 low immunological risk recipients between December 2005 and July 2010. Study cohort (ESW-C N=32), steroid withdrawal was carried out after 5 days, while they were receiving tacrolimus/mycophenolate mofetil. The control cohort (C-C, N=28) received prednisone/tacrolimus/mycophenolate mofetil. Clinical, biochemical and histological variables were assessed at baseline and after 3, 6, and 12 months of follow-up. Kaplan-Meier and the Cox proportional hazards model were used to assess survival. Comparisons between cohorts were carried out by the Student's t and c2 tests. RESULTS: At follow-up, C-C displayed significantly higher systolic (125 ± 10 vs. 114 ± 8) and diastolic (81 ± 8 vs. 72 ± 7) blood pressure, serum glucose (96 ± 13 vs. 86 ± 10), triglycerides (177 ± 61 vs. 129 ± 34), total (183 ± 43 vs. 148 ± 34) and LDL-cholesterol (100 ± 22 vs. 87 ± 25). C-C had a higher proportion of antihypertensive (57 vs. 13%), and statins (27 vs. 9%) use. eGFR was better in ESW-C than in C-C (85.4 ± 20.6 vs. 70.6 ± 17.0, p=.004). AR frequency was lower in ESW-C. CONCLUSIONS: Graft survival, GFR, AR rate and metabolic profile were better in the ESW-C than in C-C.

Insertion/deletion polymorphism of the angiotensin-converting enzyme gene in lupus nephritis among Mexicans.

UNLABELLED: The angiotensin (Ang)-converting enzyme (ACE) insertion/deletion (I/D) polymorphism determines Ang II levels, but its relationship with lupus nephritis (LN) in different populations is controversial. OBJECTIVE: To describe the allelic and genotypic distribution of the I/D polymorphism in Mexican mestizos with LN and assess an association with histological classes. METHODS: We included 24 patients with systemic lupus erythematosus (SLE) without nephropathy, 41 with LN, 144 healthy subjects, and 36 with primary glomerulonephritis (GMN). Three ACE I/D polymorphism genotypes-ID, DD, and II--were detected by PCR using peripheral blood genomic DNA. RESULTS: Frequencies for II, ID, and DD were 0.29, 0.46, and 0.25 in the SLE group; 0.17, 0.63, and 0.20 in the LN group; 0.14, 0.5, and 0.36 in the GMN group; and 0.26, 0.52, and 0.22 among healthy subjects. The I/D polymorphism distribution according to histological class was class II: 1 II, 3 ID, and 1 DD; class III: 2 II, 10 ID, and 1 DD; class IV: 2 II, 9 ID, and 2 DD; class V: 2 II, 3 ID, and 4 DD; and class VI, 1 II. The histological classes with at least three patients had ID genotype as the most frequent except for class V. CONCLUSION: No association was identified between I/D polymorphisms of ACE and SLE, LN, or GMN in a Mexican population.

Improving fingerprint verification using minutiae triplets.

Improving fingerprint matching algorithms is an active and important research area in fingerprint recognition. Algorithms based on minutia triplets, an important matcher family, present some drawbacks that impact their accuracy, such as dependency to the order of minutiae in the feature, insensitivity to the reflection of minutiae triplets, and insensitivity to the directions of the minutiae relative to the sides of the triangle. To alleviate these drawbacks, we introduce in this paper a novel fingerprint matching algorithm, named M3gl. This algorithm contains three components: a new feature representation containing clockwise-arranged minutiae without a central minutia, a new similarity measure that shifts the triplets to find the best minutiae correspondence, and a global matching procedure that selects the alignment by maximizing the amount of global matching minutiae. To make M3gl faster, it includes some optimizations to discard non-matching minutia triplets without comparing the whole representation. In comparison with six verification algorithms, M3gl achieves the highest accuracy in the lowest matching time, using FVC2002 and FVC2004 databases.

Pentoxifylline decreases serum levels of tumor necrosis factor alpha, interleukin 6 and C-reactive protein in hemodialysis patients: results of a randomized double-blind, controlled clinical trial.

AIM: The aim of this study was to compare the effect of pentoxifylline versus placebo on serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6) and C-reactive protein (CRP) of hemodialysis (HD) patients. METHODS: This is a randomized double-blind, controlled clinical trial. HD patients without infection or drugs with anti-inflammatory effect were randomly allocated to a study (n = 18, pentoxifylline 400 mg/day) or control (n = 18, placebo) group; all patients had arteriovenous fistula. Besides clinical and laboratory monthly assessments, serum TNF-α and IL-6 (ELISA) and CRP (nephelometry) were measured at 0, 2 and 4 months. RESULTS: All the inflammation markers significantly (P < 0.05) decreased in the pentoxifylline group: TNF-α [baseline 0.4 (0-2) versus final 0 (0-0) pg/mL], IL-6 [baseline 9.4 (5-14) versus final 2.9 (2-5) pg/mL] and CRP [baseline 7.1 (3-20) versus final 2.6 (1-8) mg/L], whereas no significant changes were observed in the placebo group: TNF-α [baseline 0 (0-0) versus final 1.2 (0-4) pg/mL], IL-6 [baseline 8.0 (5-11) versus final 8.7 (4-11) pg/mL] and CRP [baseline 4.5 (2-9) versus final 3.8 (3-23) mg/L]. CONCLUSIONS: Pentoxifylline significantly decreased serum concentrations of TNF-α, IL-6 and CRP compared to placebo. Pentoxifylline could be a promising and useful strategy to reduce the systemic inflammation frequently observed in patients on HD.