Comparison of the effect of pentoxifylline and captopril on proteinuria in patients with type 2 diabetes mellitus

Objectives: To compare the relative efficacy of pentoxifylline (PTX) and angiotensin-converting enzyme ( ACE) inhibitor, captopril in the treatment of proteinuria of type 2 diabetic patients. Design: A randomized open, crossover, clinical trial conducted from October 2000 to March 2001. Setting and Participants: 39 patients with type 2 diabetes age 34 - 75 years were randomly allocated to the two treatment groups. The first group received PTX ( 400 mg three times a day) orally for a total of 2 months. The second group received captopril ( 25 mg three times a day) for 2 months. Response to treatment was assessed at 1, 2, 4, and 8 weeks after start of therapy. Results: Captopril appeared to be equivalent in efficacy and safety to PTX. A significant decrease in proteinuria occurred in both groups. Of the 20 patients treated with PTX, the mean (SD) of 24 h urinary protein decreased from 1.4 (0.7) to 1.0 ( 0.7) g/24 h ( p < 0.05). Correspondingly, in the 19 patients treated with captopril, the mean ( SD) of 24 h urinary protein decreased from 1.3 ( 0.7) to 0.8 ( 0.7) g/24 h ( p < 0.01). Conclusion: This study demonstrates that treatment with PTX and captopril both significantly reduce overt proteinuria in patients with type 2 diabetes. This effect of ACE inhibition has previously been shown to slow progression to renal failure and we postulate that treatment with PTX may have a similar benefit. Copyright (C) 2005 S. Karger AG, Basel.