Effect of Pentoxifylline on Renal Function and Urinary Albumin Excretion in Patients with Diabetic Kidney Disease: The PREDIAN Trial

Diabetic kidney disease (DKD) is the leading cause of ESRD. We conducted an open-label, prospective, randomized trial to determine whether pentoxifylline (PTF), which reduces albuminuria, in addition to renin-angiotensin system (RAS) blockade, can slow progression of renal disease in patients with type 2 diabetes and stages 3–4 CKD. Participants were assigned to receive PTF (1200 mg/d) ( n =82) or to a control group ( n =87) for 2 years. All patients received similar doses of RAS inhibitors. At study end, eGFR had decreased by a mean±SEM of 2.1±0.4 ml/min per 1.73 m 2 in the PTF group compared with 6.5±0.4 ml/min per 1.73 m 2 in the control group, with a between-group difference of 4.3 ml/min per 1.73 m 2 (95% confidence interval [95% CI], 3.1 to 5.5 ml/min per 1.73 m 2 ; P 2 per month) was lower in the PTF group than in the control group (33.3% versus 68.2%; P P =0.001). Urine TNF- α decreased from a median 16 ng/g (interquartile range, 11–20.1 ng/g) to 14.3 ng/g (interquartile range, 9.2–18.4 ng/g) in the PTF group ( P