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Therapeutic efficacy of pentoxifylline on proteinuria and renal progression: an update.
J Biomed Sci. 2017 Nov 13; 24(1):84.JB

Abstract

Blood pressure control with renin-angiotensin system (RAS) blockade has remained the gold standard for treating patients with proteinuric chronic kidney disease (CKD) up to date. Nevertheless, RAS blockade slows but does not halt the progression of kidney disease, thus highlighting the need to search for additional therapeutic approaches. The nonselective phosphodiesterase (PDE) inhibitor pentoxifylline (PTX) is an old drug that exhibits prominent anti-inflammatory, anti-proliferative and anti-fibrotic activities both in vitro and in vivo. Studies in human subjects have shown that PTX monotherapy decreases urinary protein excretion, and add-on therapy of PTX to background RAS blockade additively reduces proteinuria in patients with CKD of various etiology. More recent studies find that PTX combined with RAS blockade delays the decline of glomerular filtration rate in diabetic patients with mild to moderate CKD, and reduces the risk of end-stage renal disease in diabetic and non-diabetic patients in late stage of CKD with high proteinuria levels. In this review, we update the clinical trial results of PTX as monotherapy, or in conjunction or in comparison with RAS blockade on patients with proteinuria and CKD, and propose a mechanistic scheme explaining the renoprotective activities of this drug.

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Authors+Show Affiliations

Chen YM
Renal Division, Department of Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, Taiwan. chenym@ntuh.gov.tw.
Chiang WC
Renal Division, Department of Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, Taiwan.
Lin SL
Renal Division, Department of Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, Taiwan. linsl@ntu.edu.tw. Graduate Institute of Physiology, College of Medicine, National Taiwan University, No. 1, Jen-Ai Road, Section 1, Taipei, Taiwan. linsl@ntu.edu.tw.
Tsai TJ
Renal Division, Department of Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, Taiwan.

MeSH

Disease ProgressionKidney Failure, ChronicPentoxifyllinePhosphodiesterase InhibitorsProteinuriaRenal Insufficiency, Chronic

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29132351

Citation

Chen, Yung-Ming, et al. "Therapeutic Efficacy of Pentoxifylline On Proteinuria and Renal Progression: an Update." Journal of Biomedical Science, vol. 24, no. 1, 2017, p. 84.
Chen YM, Chiang WC, Lin SL, et al. Therapeutic efficacy of pentoxifylline on proteinuria and renal progression: an update. J Biomed Sci. 2017;24(1):84.
Chen, Y. M., Chiang, W. C., Lin, S. L., & Tsai, T. J. (2017). Therapeutic efficacy of pentoxifylline on proteinuria and renal progression: an update. Journal of Biomedical Science, 24(1), 84. https://doi.org/10.1186/s12929-017-0390-4
Chen YM, et al. Therapeutic Efficacy of Pentoxifylline On Proteinuria and Renal Progression: an Update. J Biomed Sci. 2017 Nov 13;24(1):84. PubMed PMID: 29132351.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapeutic efficacy of pentoxifylline on proteinuria and renal progression: an update. AU - Chen,Yung-Ming, AU - Chiang,Wen-Chih, AU - Lin,Shuei-Liong, AU - Tsai,Tun-Jun, Y1 - 2017/11/13/ PY - 2017/07/25/received PY - 2017/10/30/accepted PY - 2017/11/15/entrez PY - 2017/11/15/pubmed PY - 2018/6/26/medline KW - CKD KW - ESRD KW - Pentoxifylline KW - Proteinuria KW - Renin-angiotensin system SP - 84 EP - 84 JF - Journal of biomedical science JO - J Biomed Sci VL - 24 IS - 1 N2 - Blood pressure control with renin-angiotensin system (RAS) blockade has remained the gold standard for treating patients with proteinuric chronic kidney disease (CKD) up to date. Nevertheless, RAS blockade slows but does not halt the progression of kidney disease, thus highlighting the need to search for additional therapeutic approaches. The nonselective phosphodiesterase (PDE) inhibitor pentoxifylline (PTX) is an old drug that exhibits prominent anti-inflammatory, anti-proliferative and anti-fibrotic activities both in vitro and in vivo. Studies in human subjects have shown that PTX monotherapy decreases urinary protein excretion, and add-on therapy of PTX to background RAS blockade additively reduces proteinuria in patients with CKD of various etiology. More recent studies find that PTX combined with RAS blockade delays the decline of glomerular filtration rate in diabetic patients with mild to moderate CKD, and reduces the risk of end-stage renal disease in diabetic and non-diabetic patients in late stage of CKD with high proteinuria levels. In this review, we update the clinical trial results of PTX as monotherapy, or in conjunction or in comparison with RAS blockade on patients with proteinuria and CKD, and propose a mechanistic scheme explaining the renoprotective activities of this drug. SN - 1423-0127 UR - https://www.unboundmedicine.com/medline/citation/29132351/Therapeutic_efficacy_of_pentoxifylline_on_proteinuria_and_renal_progression:_an_update_ DB - PRIME DP - Unbound Medicine ER -