Effect of pentoxifylline on proteinuria, markers of tubular injury and oxidative stress in non-diabetic patients with chronic kidney disease - placebo controlled, randomized, cross-over study

被引:0
作者
Renke, Marcin [1 ]
Tylicki, Leszek [1 ]
Rutkowski, Przemyslaw [1 ]
Knap, Narcyz [2 ]
Zietkiewicz, Marcin [3 ]
Neuwelt, Alexander [4 ]
Aleksandrowicz, Ewa [5 ]
Lysiak-Szydlowska, Wieslawa [5 ]
Wozniak, Michal [2 ]
Rutkowski, Boleslaw [1 ]
机构
[1] Med Univ Gdansk, Dept Nephrol Transplantol & Internal Med, Gdansk, Poland
[2] Med Univ Gdansk, Dept Med Chem, Gdansk, Poland
[3] Med Univ Gdansk, Dept Internal Med Connect Tissue Dis & Geriatr, Gdansk, Poland
[4] Oregon Hlth & Sci Univ, Blood Brain Barrier & Neurooncol Program, Portland, OR 97201 USA
[5] Med Univ Gdansk, Dept Clin Nutr & Lab Diagnost, Gdansk, Poland
关键词
pentoxifylline; oxidative stress; kidney; chronic kidney disease; proteinuria; tubular injury; ACETYL-BETA-GLUCOSAMINIDASE; C-REACTIVE PROTEIN; RENIN-ANGIOTENSIN SYSTEM; DOSE DUAL BLOCKADE; PRIMARY GLOMERULONEPHRITIS; THERAPEUTIC EFFICACY; RECEPTOR ANTAGONISTS; CELLS; DYSFUNCTION; PROGRESSION;
D O I
暂无
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Background: Inhibition of the renin-angiotensin-aldosterone system (RAAS) with angiotensin converting enzyme inhibitors (ACEI) and/or angiotensin II subtype 1 receptor antagonists (ARB) is a common strategy used in the management of patients with chronic kidney disease (CKD). However, there is no universal therapy that can stop progression of CKD. Pentoxifylline (PTE) is a nonspecific phosphodiesterase inhibitor with anti-inflammatory properties. It has been reported to have promising effects in CKD treatment. Methods: In a placebo-controlled, randomized, cross-over study we evaluated the influence of PTE (1200 mg/day) added to RAAS blockade on proteinuria, surrogate markers of tubular injury and oxidative stress-dependent products in 22 non-diabetic patients with proteinuria (0.4-4.3 g per 24 h) with normal or declined kidney function [eGFR 37-178 mL/min]. In an eight-week run-in period, therapy using ACEI and/or ARB was adjusted to achieve a blood pressure below 130/80 mm Hg. Next, patients were randomly assigned to one of two treatment sequences: PTE/washout/placebo or placebo/washout/PTE. Clinical evaluation and laboratory tests were performed at the randomization point and after each period of the study. Results: The PTE therapy reduced proteinuria (by 26%) as compared to placebo. There were no differences in alpha(1)-microglobulin, urine excretion of N-acetyl-beta-D-glucosaminidase (NAG), hsCRP, the urinary excretion of 15-F-2t-isoprostane, blood pressure (BP), eGFR and serum creatinine between the PTE and placebo groups. Conclusion: Pentoxifylline may decrease proteinuria in non-diabetic patients with CKD.
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页码:119 / 123
页数:5
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