Can pentoxifylline be used as adjunct therapy to ACE inhibitors and ARBs in preserving kidney function?

Abstract

Purpose. To determine if there is sufficient evidence to recommend the addition of pentoxifylline to standard ACE inhibitor and ARB therapy in chronic kidney disease patients to reduce proteinuria and preserve kidney function. Methods: A search of the literature was conducted using the PubMed.gov and ClinicalTrials.gov search engines and the search terms “pentoxifylline renoprotection”, “pentoxifylline CKD”, and “pentoxifylline nephropathy”. Results were limited to studies in human subjects and published in the English language. No date range was specified. Studies focused on the effects of pentoxifylline on drug induced nephropathy were excluded. Results: Nine relevant articles were retrieved and evaluated. The two main populations studied were patients with chronic kidney disease (CKD) and patients with CKD and comorbid type 2 diabetes. Six of the nine studies reported a significant reduction in proteinuria in pentoxifylline treated patients. Four studies reported a significant change in estimated glomerular filtration rate (eGFR). Conclusion: Addition of pentoxifylline to ACE inhibitor and ARB therapy may improve proteinuria in CKD patients. There is conflicting evidence as to whether pentoxifylline will improve kidney function as measured by eGFR.