Effect of pentoxifylline on the evolution of diabetic nephropathy

Background and objective: Diabetic nephropathy (DN) is the principal cause of end-chronic kidney disease. Metabolic and hemodynamic components are directly involved. However, convincing data have shown that inflammation participates in the diabetic complications. The aim of this study was to investigate whether the inhibition of the inflammation and pro-inflammatory cytokines with pentoxifylline (PXF) attenuate the progression of the, DN. Subjects and method: in a prospective, randomized, double-blind, placebo-controlled study, we evaluated the effect of PXF (1200 mg daily) during 12 months, in 34 patients with incipient or established DN. Evaluated parameters were inflammation, pro-inflammatory cytokines and urinary albumin excretion (UAE). Results: PXF treatment had a reno-protective effect determined by a significant reduction in the UAE in both incipient and established (p<0.01) DN patient. This effect was attributed to a reduction in the C-reactive protein, interleukin-6, tumor necrosis factor-a and leptin serum levels (p<0.01). Conclusions: PXF treatment caused regression and prevented the progression of renal damage. Thus, PXF should be used in the preventive treatment of DN. These results showed that inflammation and pro-inflammatory cytokines are related to the progression of diabetic nephropathy. (C) 2007 Elsevier Espana, S.L. All rights reserved.