Effect of Pentoxifylline on Inflammatory Marker in Non-Diabetic Chronic Kidney Disease Patients

Abstract Background Chronic kidney disease is a progressive condition that affects >10% of the general population worldwide, amounting to > 800 million individuals in 2017. CKD has emerged as one of the most prominent causes of death and suffering in the 21st century. Aim of the Work To assess the effect of pentoxifylline on inflammatory marker and Chronic Kidney Disease progression in non- diabetic chronic kidney disease. Patients and Methods The current study design was a prospective, interventional, open- label, randomized controlled clinical trial conducted on adult patients with Chronic Kidney Disease at the outpatient clinics of AinShams University hospital, Cairo, Egypt, from the start of February (2023) to the end of July (2023). Results TNF-alpha, CRP, UPCR, and GFR were measured at baseline and after a six-month follow-up period. TNF-alpha and CRP levels were determined using enzyme-linked immunosorbent assay (ELISA) kits, while UPCR was calculated by dividing the urinary protein concentration by the urinary creatinine concentration. GFR was estimated using CKD-EPI. The results of this study showed a significant decrease in CRP levels in group 2 compared to group 1, indicating a greater reduction in systemic inflammation with the addition of Pentoxifylline. Similarly, UPCR decreased significantly in group 2, suggesting a beneficial effect of Pentoxifylline on proteinuria. In contrast, there was no statistical difference in the reduction of TNF-alpha levels between the two groups, although both groups exhibited a significant decrease in TNF-alpha. Furthermore, there was no significant difference in GFR changes between the two groups. Conclusion The addition of pentoxifylline to the standard therapy in non-diabetic CKD patients resulted in a significant reduction in CRP levels and proteinuria, indicating its potential as an adjunctive treatment to mitigate inflammation and proteinuria. However, no significant difference was observed in the reduction of TNF-alpha levels or GFR changes between the two groups. These findings suggest that pentoxifylline's anti-inflammatory effects may be mediated through pathways other than TNF-alpha inhibition. Further research is warranted to explore the underlying mechanisms and optimize the use of pentoxifylline in the management of CKD patients.