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Objectives: To assess the benefits and harms of pentoxifylline for treating people with DKD.
The relevance of inflammation in the pathogenesis of DKD has been investigated in recent years, and it has been shown that inflammatory markers are higher in people with DKD compared with the wider population.The adverse events of pentoxifylline were mild; no serious adverse events were reported in any of the included studies.Pentoxifylline seemed to have some beneficial effects in improving kidney function and reducing albuminuria and proteinuria (which can indicate kidney health) for patients with DKD, and was not associated with any major adverse effects.Cr Cl was significantly increased when pentoxifylline was compared to clonidine/methyldopa (MD 10.90 m L/min, 95% CI ‐1.40 to 20.40) but not with captopril (MD 3.26 m L/min, 95% CI ‐1.05 to 7.59).No data were available on the incidence of end stage kidney disease (ESKD), time to ESKD, quality of life, or all‐cause mortality.Mean differences (MD) were calculated to assess the effects of treatment where outcomes were expressed on continuous scales, and standardised mean differences (SMD) calculated where different scales were used. Adverse effects were assessed using descriptive techniques and where possible, risk differences (RD) with 95% CI.
Main results: We identified 17 studies that included a total of 991 participants with DKD which met our inclusion criteria.Authors' conclusions: From the available evidence, pentoxifylline seems to offer some beneficial effects in renal function improvement and reduction in albuminuria and proteinuria, with no obvious serious adverse effects for patients with DKD.However, most studies were poorly reported, small, and methodologically flawed.Cr Cl was significantly increased when pentoxifylline was compared to clonidine/methyldopa but not with captopril.No data were available on the incidence of ESKD, time to ESKD, quality of life, or all‐cause mortality.We reviewed 17 randomised controlled studies, enrolling 991 patients with DKD, which compared pentoxifylline with placebo, routine treatment or antihypertensive drugs.