Shayanpour Shokouh, Mehri Aslan, Hayati Fatemeh, Zakerkish Mehrnoosh, Beladi Mousavi Seyed Seifollah, Hoseinynejad Khojasteh
Department of Internal Medicine, Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Recenti Prog Med. 2024 Jan;115(1):15-20. doi: 10.1701/4169.41640.
Diabetic nephropathy is a clinical syndrome characterized by persistent albuminuria and progressive impairment in renal function. Pentoxifylline is a non-specific inhibitor of phosphodiesterase with anti-inflammatory properties which may have therapeutic potency in patients with diabetic kidney disease.
The present study is aimed at evaluating the efficacy of pentoxifylline as a treatment strategy for alleviating the microalbuminuria in type-2 diabetic patients with nephropathy.
This double-blind randomized clinical trial was performed on outpatients with type 2 diabetic nephropathy who presented urine albumin excretion of 30-300 mg per 24 hours on at least three consecutive occasions. A total of 58 patients were randomly assigned to the treatment and control groups. The treatment group (n=29) received pentoxifylline (400 mg/day) for 3 months in addition to the standard drugs for diabetic nephropathy (Raas blockers), while the control group (n=29) received placebo as add-on therapy. Finally, urine albumin test was measured before and after 3 months of treatment and compared between the two groups.
Before the intervention, no significant difference in the levels of albuminuria was observed between the two groups (153.21±130.80 mg/day vs. 159.93 ±130.45; p=0.845); but after 12 weeks of treatment, albuminuria in the treatment group was significantly reduced compared to the placebo group (29.59 ±27.88 mg/day vs. 160.48±129.53 mg/day; p<0.0001). At the end of the study, the response rate to treatment (more than 50% reduction in albuminuria) was 89.7% in the pentoxifylline group, while no response to treatment was observed in the placebo group (p<0.0001).
Pentoxifylline as add-on therapy to the conventional treatment (Raas blockers) may reduce the microalbuminuria in patients with diabetic nephropathy without any side effects.
糖尿病肾病是一种以持续性蛋白尿和肾功能进行性损害为特征的临床综合征。己酮可可碱是一种具有抗炎特性的非特异性磷酸二酯酶抑制剂，可能对糖尿病肾病患者具有治疗效力。
本研究旨在评估己酮可可碱作为一种治疗策略减轻2型糖尿病肾病患者微量白蛋白尿的疗效。
本双盲随机临床试验针对2型糖尿病肾病门诊患者进行，这些患者至少连续三次24小时尿白蛋白排泄量为30 - 300毫克。总共58例患者被随机分配到治疗组和对照组。治疗组（n = 29）除接受糖尿病肾病标准药物（肾素 - 血管紧张素 - 醛固酮系统阻滞剂）外，还接受己酮可可碱（400毫克/天）治疗3个月，而对照组（n = 29）接受安慰剂作为附加治疗。最后，在治疗3个月前后测量尿白蛋白试验，并在两组之间进行比较。
干预前，两组蛋白尿水平无显著差异（153.21±130.80毫克/天 vs. 159.93±130.45毫克/天；p = 0.845）；但治疗12周后，治疗组的蛋白尿水平与安慰剂组相比显著降低（29.59±27.88毫克/天 vs. 160.48±129.53毫克/天；p<0.0001）。在研究结束时，己酮可可碱组的治疗反应率（蛋白尿减少超过50%）为89.7%，而安慰剂组未观察到治疗反应（p<0.0001）。
己酮可可碱作为传统治疗（肾素 - 血管紧张素 - 醛固酮系统阻滞剂）的附加治疗，可能降低糖尿病肾病患者的微量白蛋白尿，且无任何副作用。
