Araştırma Makalesi
Yıl 2022,
Cilt: 17 Sayı: 3, 188 - 192, 02.11.2022
Öz
Abstract
Objective: Diabetic nephropathy (DN) is an important cause of end stage renal disease. It has been suggested that pentoxifylline, which is used for the treatment of vascular diseases, has anti-inflammatory properties and may have positive effects on diabetic nephropathy. In this study, we aimed to investigate the effect of pentoxifylline treatment on renal functions and proteinuria levels in patients with DN.
Material and Methods: Thirty-six DN patients treated with 1200 mg/day pentoxifylline were screened retrospectively. Twenty-four-hour proteinuria and estimated glomerular filtration rate (eGFR) values were recorded at 3rd and 6th months before starting treatment and at 3rd, 6th and 12th months of pentoxifylline treatment.
Results: The average age was 51.9±12.3 years. In this patient cohort, 12 were male and 16 were using angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB). Twenty-three patients used pentoxifylline for less than 6 months (group A) and 13 patients used it for more than 6 months (group B). There was no difference between groups A and B regarding the amount of 24-hour proteinuria (Group A: 3.76±2.49 g/day, Group B: 4.72±3.20 g/day, p=0.423) and loss of eGFR (Group A: 37.98±31.2 ml/min, Group B: 34.00±29.99 ml/min, p=0.846).
Conclusion: In this study, the effect of pentoxifylline on proteinuria and eGFR loss was not observed in patients with diabetic nephropathy during 1-year follow-up.
Anahtar Kelimeler
Kaynakça
- Lai TS, Chiang W, Chen Y. Pentoxifylline: Evidence strong enough for renoprotection? J Formos Med Assoc. 2016;115(8):591-592.
- Bhanot S, Leehey DJ. Pentoxifylline for diabetic nephropathy: An Important Opportunity to Re-purpose an Old Drug? Curr Hypertens Rep. 2016;18(1):8.
- Han SJ, Kim HJ, Kim DJ, Sheen SS, Chung CH, Ahn CW et al. Effects of pentoxifylline on proteinuria and glucose control in patients with type 2 diabetes: A prospective randomized double-blind multicenter study. Diabetol Metab Syndr 2015;7:64.
- Navarro-Gonzalez JF, Mora-Fernandez C, Muros de Fuentes M, Chahin J, Méndez ML, Gallego E et al. Effect of pentoxifylline on renal function and urinary albumin excretion in patients with diabetic kidney disease: the PREDIAN trial. J Am Soc Nephrol. 2015;26(1):220-229.
- Fouli GE, Gnudi L. The Future: Experimental therapies for renal disease in diabetes. Nephron. 2019;143(1):3-7.
- De Zeeuw D, Remuzzi G, Parving H, Keane WF, Zhang Z, Shahinfar S et al. Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL. Kidney Int. 2004;65(6):2309–2320.
- Wu PC, Wu CJ, Lin CJ, Pan CF, Chen CY, Huang TM et al. Pentoxifylline decreases dialysis risk in patients with advanced chronic kidney disease. Clin Pharmacol Ther. 2015;98(4):442-449.
- Rabizadeh S, Firouzabadi FD, Esteghamati S, Afarideh M, Ghajar A et al. Beneficial effects of pentoxifylline plus losartan dual therapy in type 2 diabetes with nephropathy Am J Med Sci. 2018 May;355(5):442-448.
- Navarro-González JF, Sánchez-Niño MD, Donate-Correa H, Martín-Núñez E, Ferri C, Pérez-Delgadoet N et al. Effects of pentoxifylline on soluble klotho concentrations and renal tubular cell expression in diabetic kidney disease. Diabetes Care. 2018;41(8):1817-1820.
- Tian ML, Shen Y, Sun ZL, Zha Y. Efficacy and safety of combining pentoxifylline with angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker in diabetic nephropathy: A meta-analysis. Int Urol Nephrol. 2015;47(5):815–822.
- Lin SL, Chen YM, Chiang WC, Wu KD, Tsai TJ. Effect of pentoxifylline in addition to losartan on proteinuria and GFR in CKD: A 12-month randomized trial. Am J Kidney Dis. 2008;52(3):464-474.
Yıl 2022,
Cilt: 17 Sayı: 3, 188 - 192, 02.11.2022
Öz
Özet
Amaç: Diabetik nefropati (DN) son dönem böbrek yetersizliğinin önemli bir nedenidir. Vasküler hastalıklarda kullanılan ve anti-inflamatuar özellikleri olan pentoksifilinin diyabetik nefropatide olumlu etkileri olabileceği öne sürülmüştür. Bu çalışmada DN nedeni ile takipte olan ve pentoksifilin kullanan hastaların tedavi öncesi ve sonrası dönemdeki böbrek fonksiyonları ve proteinürileri değerlendirilmiştir.
Gereç ve Yöntemler: Kliniğimizde takipte olup pentoksifilin (1200 mg/gün) tedavisi alan 36 diabetik nefropati hastası retrospektif olarak tarandı. Tedavi başlanmadan önceki 3. ve 6. ay; pentoksifilin tedavisinin 3., 6., 9. ve 12. aylardaki günlük proteinüri miktarı ve eGFR (estimated glomerular filtration rate, tahmini glomerüler filtrasyon hızı) değerleri kayıt edildi.
Bulgular: Çalışmaya alınan 36 hastanın ortalama yaşı 51.9±12.3 yıl, 12’si erkek ve 16’sı Anjiotensin dönüştürücü enzim (Angiotensin converting enzyme inhibitor, ACEİ) ya da Anjiotensin reseptör blokeri (Angiotensin receptor blocker, ARB) kullanıyordu. Pentoksifilini 23 hasta ≤6 ay (A grubu) 13 hasta >6 ay (B grubu) süre kullanmıştı. Proteinüri miktarı ve eGFR kaybı yönünden her iki grupta anlamlı farklılık saptanmadı.
Sonuç: Çalışmamızda diabetik nefropatili hastalarda 1 yıllık takip sırasında pentoksifilin tedavisinin proteinüri miktarı ve eGFR kaybına etkisi saptanamamıştır.
Anahtar Kelimeler
Kaynakça
- Lai TS, Chiang W, Chen Y. Pentoxifylline: Evidence strong enough for renoprotection? J Formos Med Assoc. 2016;115(8):591-592.
- Bhanot S, Leehey DJ. Pentoxifylline for diabetic nephropathy: An Important Opportunity to Re-purpose an Old Drug? Curr Hypertens Rep. 2016;18(1):8.
- Han SJ, Kim HJ, Kim DJ, Sheen SS, Chung CH, Ahn CW et al. Effects of pentoxifylline on proteinuria and glucose control in patients with type 2 diabetes: A prospective randomized double-blind multicenter study. Diabetol Metab Syndr 2015;7:64.
- Navarro-Gonzalez JF, Mora-Fernandez C, Muros de Fuentes M, Chahin J, Méndez ML, Gallego E et al. Effect of pentoxifylline on renal function and urinary albumin excretion in patients with diabetic kidney disease: the PREDIAN trial. J Am Soc Nephrol. 2015;26(1):220-229.
- Fouli GE, Gnudi L. The Future: Experimental therapies for renal disease in diabetes. Nephron. 2019;143(1):3-7.
- De Zeeuw D, Remuzzi G, Parving H, Keane WF, Zhang Z, Shahinfar S et al. Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL. Kidney Int. 2004;65(6):2309–2320.
- Wu PC, Wu CJ, Lin CJ, Pan CF, Chen CY, Huang TM et al. Pentoxifylline decreases dialysis risk in patients with advanced chronic kidney disease. Clin Pharmacol Ther. 2015;98(4):442-449.
- Rabizadeh S, Firouzabadi FD, Esteghamati S, Afarideh M, Ghajar A et al. Beneficial effects of pentoxifylline plus losartan dual therapy in type 2 diabetes with nephropathy Am J Med Sci. 2018 May;355(5):442-448.
- Navarro-González JF, Sánchez-Niño MD, Donate-Correa H, Martín-Núñez E, Ferri C, Pérez-Delgadoet N et al. Effects of pentoxifylline on soluble klotho concentrations and renal tubular cell expression in diabetic kidney disease. Diabetes Care. 2018;41(8):1817-1820.
- Tian ML, Shen Y, Sun ZL, Zha Y. Efficacy and safety of combining pentoxifylline with angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker in diabetic nephropathy: A meta-analysis. Int Urol Nephrol. 2015;47(5):815–822.
- Lin SL, Chen YM, Chiang WC, Wu KD, Tsai TJ. Effect of pentoxifylline in addition to losartan on proteinuria and GFR in CKD: A 12-month randomized trial. Am J Kidney Dis. 2008;52(3):464-474.
Toplam 11 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 1 Kasım 2022 |
| Yayımlanma Tarihi | 2 Kasım 2022 |
| Gönderilme Tarihi | 28 Nisan 2022 |
| Kabul Tarihi | 8 Temmuz 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 17 Sayı: 3 |
