Effect of latophoxyphillin on proteinuria of nephrotic range in glomerulopathies and chronic graft nephropathy. Results after 6 months of treatment

  • César Agost Carreño Servicio de Nefrología, Hospital Aeronáutico Central, Buenos Aires
  • Marina Gadea Servicio de Nefrología, Hospital Aeronáutico Central, Buenos Aires
  • Carlos González Servicio de Nefrología, Hospital Aeronáutico Central, Buenos Aires
  • Gonzalo Carrizo Servicio de Nefrología, Hospital Aeronáutico Central, Buenos Aires
Keywords: pentoxifillyne, proteinuria, chronic renal disease, glomerulopathies, chronic allograft nephropathy

Abstract

The proteinuria has been considered as an expresión of damage or disfunction of glomerular permeabilíty, The proint1amatory cytokines play an essential role in the development of this damage. Pentoxifillyne (PTX ) is an inhibitor of phosphodiesterase and have an antiinflamatory as well as inmunomodulator effect. This study assessed the efficiency of PTX to reduce the proteinuria of nephrotic type in a group of patients with primary glomerulophaties, diabetes and chronic allograft nephropathy (CAN). Seventeen adult patients, with proteinuria > to 3.5 gr 124 hs and a glomerular filtration rate > to 25 mI Imin (MDRD) were trated with 400 mg of PTX twice a day during 6 months, without leaving the previous treatment. Laboratory results were compared before the treatment and 6 months after. There was an significant decrease of proteinuria (p=0.0006) as well as a remarkable increase of serum albumina (p=0.0002). There were no modifications as regards the renal function and besides, cholesterol and trigliceryds levels improved. In conclusion, 800 mg Iday of PTX is harmless, sure and effective to reduce the proteinuria in glomerulopathies and CAN, despite the renal function degree.

References

Keane W. Proteinuria: its c1inical importance and role in progressive renal disease. Am J Kidney Dis 2000; 35: S 97-105.

Igeki K, Ikemiya Y, Iseki K. Takishita, Proteinuria and the risk of developing end stage renal disease, Kidney Int 2003; 63: 1468-1474.

Remuzzi G, Schieppati A, Ruggementi P. Nephropathy in patients with type II diabetes N E J Med 2002; 346: 1145-1151.

Levey A S. Nondiabetic kidney disease. N E J Med 2002; 347:1505-1511.

Ruggementi P, Perna A, Remuzzi G. Retarding progression of chronic renal disease: the neglected issue of residual proteinuria. Kidney Int, 2003;63: 2254-2261.

Comprehensive Clinical Nephrology- 3rd. Edition 2007. John Feehally et al. Mosby Elsevier, p 187.

Antignac e. Molecular basis of steroid-resistant nephrotic syndrorne. Nefrología 2005, 25 (suppl. 2) 25-28.

Honkanen E, Treppo A M, Meri S, el al. Urinary excretion of cytokines and complement ScSb-9 in idiopathic membranous glomerulonephritis. Nephrol Dial Transplant 1994; 9: 1553-1559.

Honkanen E, Von Willebrand E, Treppo A M et al. Adhesion molecules and urinary tumor necrosis factor-alpha in idiopathic membranous glomerulonephritis. Kidney Int.l998; 53: 909-917.

RovinB H, Dol N, Tan Le. Monocytechemoattractan protein-I levels in patients with glomerular disease. Am J Kidney Dis 1996;27: 640-646.

Tam F W, Sanders J S, George A et al. Urinary monocyte chemoattractant protein-I is a marker of active renal vasculitis. Nephrol Dial Transplant 2004; 19: 2761-2768.

Zandi-Nejad K. Eddy A A, Glassock R J, Bremer B M. Why is proteinuria an ominous biomarker of progressive kidney disease? Kidney Int 2004; 66 (suppl 92) 576-589.

Jacoby D, Mohler III E R. Drug treatment of intermittent claudication, Drugs 2004; 64: 1657-1670.

Lin S L, Chen Y M, Chiang W C et al. Pentoxifylline a potential therapy for chronic kidney disease, Nephrology 2004; 9: 198-204.

Ducloux D, Bresson-Vauntrin C. Chalopin J. Use of pentoxifillyne in membranous nephopathy, Lancet 2001; 357: 1672-1673.

Galindo-Rodriguez G, Bustamante R, Esquivel Nava G et al. Pentoxifillyne in the treatment of refractory nephrotic syndrome secondary to lupus nephritis. J Rheumatol 2003; 30: 2382-2384.

Navarro J F, Mora C, Rivero A et al, Urinary protein excretion and serum tumor necrosis factor in diabetic patients with advanced renal failure: effects ofpentoxifillyne administration. Am J Kidney Dis 1999; 33: 458-463.

Navarro J F, Mora C, Muros M et al. Effects of pentoxifillyne administration on urinary N-acetylglucosaminidase excretion on type 2 diabetic patients; a short -terrn, prospective randomized study. Am J Kidney Dis 2003; 42: 2916-2929.

Shu K H, Wu M J, Cheng H et al. Effect of pentoxifillyne on graft function of renal transplant recipients complicated with chronic allograft nephropathy. Clin Nephrol 2007; 67 (S) 157-163.

Chen Y M, Lin S L, Chiang W C et aL Pentoxifillyne ameliorates proteinuria through suppression of renal monocyte chemoattractant protein-I in patients with proteinuric primary glomerular diseases. Kidney Int 2006; 69: 1410-1415.

Levey A S, Greene T. Kusek J W, MDRD Study Group. A simplified equation to predict glomerular filtration rate from serum creatinine (abstraer) J Am Soc Nephrol 2000 Sep; 11: 155A.

Paap C M, Simpson K S, Horton M W et al, Multiple -dose pharmacokinetics of pentoxifillyne and its metabolites during renal insufficiency. Ann Pharmacother 1996; 30: 724-729.

Shimizu S, Nakashima H, Masutami K et aL Anti-monocyte chemoattractant protein-l gene therapy attenuates nephritis in MRLlIpr mice. Rheumathology (Oxford) 2004; 43: 1121-1128.

Wu H, Wang Y, Tay Y et al. DNA vaccination with naked DNA encoding MCP-l and RANTES protects against renal injury in adriamycin nephrothy. Kidney Int 2005; 67: 2178-2186.

Aminorroaya A, Janghorbani M, Rezvanian H, Aminian T, Gharavi M, Amini M. Comparison of the effect of pentoxifylline and captopril on proteinuria in patients with type 2 diabetes mellitus. Nephron Clin Pract. 2005;99(3):c73-7.

Harrnankaya O, Seber S, Yilmaz M. Combination of pentoxifillyne with angiotensing converting enzyme inhibitors produces an additional reduction in microalbuminuria in hypertensive type 2 diabetic patients, Renal Fail 2003; 25: 465-470.

Navarro J F, Mora C, Muros M et al. Additive antiproteinuric effect of pentoxifillyne in patients with type 2 diabetic under angiotensing U receptor blockade: a short-terrn, randomized, controlled trial. J Am Soc Nephrol 2005, 16: 2119-2126.

Brenner B M, Zagrobelny J. Clinicalrenoprotection trials involving angiotensing U-receptor antagonist and angiotensin-convertingenzyme inhibitors. Kidney Int 2003; 63 (Suppl. 82)377-585.

Rodriguez-Morán M, González G, Bermúdez-Barba M V et al. Effects oí pentoxifillyne on the urinary protein excretion profile of type 2 diabetic patients with microproteinuria: a double -blind, placebo- controlled randomized trial. Clin Nephrol 2006; 66(1): 3-10.

Ravera R E M, Weiss U et Al. Emerging therapeutic strategies in diabetic nephropathy. J Nephrol 2007; 20 (S 12) 23-32.

Published
2019-04-05
How to Cite
1.
Agost Carreño C, Gadea M, González C, Carrizo G. Effect of latophoxyphillin on proteinuria of nephrotic range in glomerulopathies and chronic graft nephropathy. Results after 6 months of treatment. Rev Nefrol Dial Traspl. [Internet]. 2019Apr.5 [cited 2024May13];28(1):9-12. Available from: http://www.revistarenal.org.ar/index.php/rndt/article/view/414
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Original Article