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Erschienen in: International Urology and Nephrology 4/2019

04.03.2019 | Nephrology - Original Paper

Pentoxifylline for the prevention of contrast-induced nephropathy in diabetic patients undergoing angioplasty: a randomized controlled trial

verfasst von: Naser Aslanabadi, Roghayeh Afsar Gharebagh, Saba Moharramzadeh, Taher Entezari-Maleki

Erschienen in: International Urology and Nephrology | Ausgabe 4/2019

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Abstract

Objectives

Contrast-induced nephropathy (CIN) is one of the most important complications of contrast media. We aimed to evaluate the preventive effects of pentoxifylline (PTX) on CIN in diabetic patients undergoing angioplasty using cystatin C.

Materials and methods

The present study was a randomized clinical trial, which was investigated the impact of PTX in the prevention of CIN among 90 diabetic patients undergoing the angioplasty using cystatin C as a novel biomarker of renal injury. The patients randomly were allocated 1:1 into the intervention and the control groups. The intervention group received a total of 1200 mg PTX orally before the angioplasty. The serum level of cystatin C and creatinine was measured at baseline and 24 h after the procedure.

Results

The incidence of CIN was 8.9% in the PTX group vs. 6.7% in the control group (p = 1.00). The baseline level of cystatin C was 1.31 ± 0.39 mg/L in the PTX group and 1.24 ± 0.42 mg/L in the control group (p = 0.561). After angioplasty, the level of cystatin C was increased to 1.33 ± 0.61 in PTX group and to 1.31 ± 0.47 in the control group but was not statistically significant. The similar pattern was also seen in the level of serum creatinine.

Conclusions

The results of this study did not support the potential benefit of PTX in the prevention of CIN in diabetic patients undergoing angioplasty.
Literatur
2.
Zurück zum Zitat Bartorelli AL, Marenzi G (2008) Contrast-induced nephropathy. J Interv Cardiol 21(1):74–85. (Epub 2007 Dec 12)CrossRefPubMed Bartorelli AL, Marenzi G (2008) Contrast-induced nephropathy. J Interv Cardiol 21(1):74–85. (Epub 2007 Dec 12)CrossRefPubMed
3.
Zurück zum Zitat Zhang M, Xu Y-J, Mengi SA, Arneja AS, Dhalla NS (2004) Therapeutic potentials of pentoxifylline for treatment of cardiovascular diseases. Exp Clin Cardiol 9(2):103–111PubMedCentralPubMed Zhang M, Xu Y-J, Mengi SA, Arneja AS, Dhalla NS (2004) Therapeutic potentials of pentoxifylline for treatment of cardiovascular diseases. Exp Clin Cardiol 9(2):103–111PubMedCentralPubMed
4.
Zurück zum Zitat Ward A, Clissold SP (1987) Pentoxifylline. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy. Drugs 34:50–97CrossRefPubMed Ward A, Clissold SP (1987) Pentoxifylline. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy. Drugs 34:50–97CrossRefPubMed
5.
Zurück zum Zitat Müller R, Lebrach F (1979) Haemorheological role of platelet aggregation and hypercoagulability in microcirculation: therapeutical approach with pentoxifylline. Pharmatherapeutica 2(6):372–379 Müller R, Lebrach F (1979) Haemorheological role of platelet aggregation and hypercoagulability in microcirculation: therapeutical approach with pentoxifylline. Pharmatherapeutica 2(6):372–379
6.
Zurück zum Zitat Dauber IM, Lesnefsky EJ, Ashmore RC et al (1992) Coronary vascular injury due to ischemia-reperfusion is reduced by pentoxifylline. J Pharmacol Exp Ther 260(3):1250–1256PubMed Dauber IM, Lesnefsky EJ, Ashmore RC et al (1992) Coronary vascular injury due to ischemia-reperfusion is reduced by pentoxifylline. J Pharmacol Exp Ther 260(3):1250–1256PubMed
7.
Zurück zum Zitat Bhat VB, Madyastha KM (2001) Antioxidant and radical scavenging properties of 8-oxo derivatives of xanthine drugs pentoxifylline and lisofylline. Biochem Biophys Res Commun 288(5):1212–1217CrossRefPubMed Bhat VB, Madyastha KM (2001) Antioxidant and radical scavenging properties of 8-oxo derivatives of xanthine drugs pentoxifylline and lisofylline. Biochem Biophys Res Commun 288(5):1212–1217CrossRefPubMed
8.
Zurück zum Zitat Freitas JP, Filipe P, Guerra-Rodrigo F (1995) Potential antioxidative effects of pentoxifylline. CRSeances Soc Biol Fil 189(3):401–405 Freitas JP, Filipe P, Guerra-Rodrigo F (1995) Potential antioxidative effects of pentoxifylline. CRSeances Soc Biol Fil 189(3):401–405
9.
Zurück zum Zitat Freitas JP, Filipe PM (1995) Pentoxifylline: a hydroxyl radical scavenger. Biol Trace Elem Res 47(1–3):307–311CrossRefPubMed Freitas JP, Filipe PM (1995) Pentoxifylline: a hydroxyl radical scavenger. Biol Trace Elem Res 47(1–3):307–311CrossRefPubMed
10.
Zurück zum Zitat Horvath B, Marton Z, Halmosi R, Alexy T, Szapary L, Vekasi J, Biro Z, Habon T, Kesmarky G, Toth K (2002) In vitro antioxidant properties of pentoxifylline, piracetam, and vinpocetine. Clin Neuropharmacol 25(1):37–42CrossRefPubMed Horvath B, Marton Z, Halmosi R, Alexy T, Szapary L, Vekasi J, Biro Z, Habon T, Kesmarky G, Toth K (2002) In vitro antioxidant properties of pentoxifylline, piracetam, and vinpocetine. Clin Neuropharmacol 25(1):37–42CrossRefPubMed
11.
Zurück zum Zitat Dávila-Esqueda ME, Martínez-Morales F (2004) Pentoxifylline diminishes the oxidative damage to renal tissue induced by streptozotocin in the rat. Exp Diabesity Res 5:245–251CrossRefPubMedCentralPubMed Dávila-Esqueda ME, Martínez-Morales F (2004) Pentoxifylline diminishes the oxidative damage to renal tissue induced by streptozotocin in the rat. Exp Diabesity Res 5:245–251CrossRefPubMedCentralPubMed
12.
Zurück zum Zitat Gale SC, Hokama JY, Ritter LS et al (2001) Pentoxifylline reduces coronary leukocyte accumulation early in reperfusion after cold ischemia. Ann Thorac Surg 71(4):1305–1311CrossRefPubMed Gale SC, Hokama JY, Ritter LS et al (2001) Pentoxifylline reduces coronary leukocyte accumulation early in reperfusion after cold ischemia. Ann Thorac Surg 71(4):1305–1311CrossRefPubMed
13.
Zurück zum Zitat Adams JG, Dhar A, Shukla SD, Silver D (1995) Effect of pentoxifylline on tissue injury and platelet-activating factor production during ischemia-reperfusion injury. J Vascul Surg 21(5):742–749CrossRef Adams JG, Dhar A, Shukla SD, Silver D (1995) Effect of pentoxifylline on tissue injury and platelet-activating factor production during ischemia-reperfusion injury. J Vascul Surg 21(5):742–749CrossRef
14.
Zurück zum Zitat Sener G, Akgun U, Satiroglu H et al (2001) The effect of pentoxifylline on intestinal ischemia/reperfusion injury. Fundam Clin Pharmacol 15(1):19–22CrossRefPubMed Sener G, Akgun U, Satiroglu H et al (2001) The effect of pentoxifylline on intestinal ischemia/reperfusion injury. Fundam Clin Pharmacol 15(1):19–22CrossRefPubMed
15.
Zurück zum Zitat Lechleitner P, Genser N, Mair J et al (1992) Pentoxifylline influences acute-phase response in acute myocardial infarction. J Mol Med 70(9):755 Lechleitner P, Genser N, Mair J et al (1992) Pentoxifylline influences acute-phase response in acute myocardial infarction. J Mol Med 70(9):755
16.
Zurück zum Zitat Krawczeski CD, Vandevoorde RG, Kathman T, Bennett MR, Woo JG, Wang Y, Griffiths RE, Devarajan P (2010) Serum cystatin C is an early predictive biomarker of acute kidney injury after pediatric cardiopulmonary bypass. Clin J Am Soc Nephrol 5(9):1552–1557CrossRefPubMedCentralPubMed Krawczeski CD, Vandevoorde RG, Kathman T, Bennett MR, Woo JG, Wang Y, Griffiths RE, Devarajan P (2010) Serum cystatin C is an early predictive biomarker of acute kidney injury after pediatric cardiopulmonary bypass. Clin J Am Soc Nephrol 5(9):1552–1557CrossRefPubMedCentralPubMed
17.
Zurück zum Zitat Yong Z, Pei X, Zhu B, Yuan H, Zhao W (2017) Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials. Sci Rep 7:41012CrossRefPubMedCentralPubMed Yong Z, Pei X, Zhu B, Yuan H, Zhao W (2017) Predictive value of serum cystatin C for acute kidney injury in adults: a meta-analysis of prospective cohort trials. Sci Rep 7:41012CrossRefPubMedCentralPubMed
18.
Zurück zum Zitat World Medical Association Declaration of Helsinki (2013) Ethical principles for medical research involving human subjects. World Medical Association. JAMA 310:2191–2194 World Medical Association Declaration of Helsinki (2013) Ethical principles for medical research involving human subjects. World Medical Association. JAMA 310:2191–2194
19.
Zurück zum Zitat Rahman MM, Haque HS, Banerjee SK, Ahsan SA, Rahman MF, Mahmood M, Salman M, Azam MG (2010) Contrast induced nephropathy in diabetic and non-diabetic patients during coronary angiogram and angioplasty. Mymensingh Med J 19:372–376PubMed Rahman MM, Haque HS, Banerjee SK, Ahsan SA, Rahman MF, Mahmood M, Salman M, Azam MG (2010) Contrast induced nephropathy in diabetic and non-diabetic patients during coronary angiogram and angioplasty. Mymensingh Med J 19:372–376PubMed
20.
Zurück zum Zitat Yavari V, Ostovan MA, Kojuri J et al (2014) The preventive effect of pentoxifylline on contrast-induced nephropathy: a randomized clinical trial. Int Urol Nephrol 46:41–46CrossRefPubMed Yavari V, Ostovan MA, Kojuri J et al (2014) The preventive effect of pentoxifylline on contrast-induced nephropathy: a randomized clinical trial. Int Urol Nephrol 46:41–46CrossRefPubMed
21.
Zurück zum Zitat Firouzi A, Eshraghi A, Shakerian F et al (2012) Efficacy of pentoxifylline in prevention of contrast-induced nephropathy in angioplasty patients. Int Urol Nephrol 44:1145–1149CrossRefPubMed Firouzi A, Eshraghi A, Shakerian F et al (2012) Efficacy of pentoxifylline in prevention of contrast-induced nephropathy in angioplasty patients. Int Urol Nephrol 44:1145–1149CrossRefPubMed
22.
Zurück zum Zitat Eshraghi A, Naranji-Sani R, Pourzand H et al (2016) Pentoxifylline and prevention of contrast-induced nephropathy: is it efficient in patients with myocardial infarction undergoing coronary angioplasty? ARYA Atheroscler 12:238–242PubMedCentralPubMed Eshraghi A, Naranji-Sani R, Pourzand H et al (2016) Pentoxifylline and prevention of contrast-induced nephropathy: is it efficient in patients with myocardial infarction undergoing coronary angioplasty? ARYA Atheroscler 12:238–242PubMedCentralPubMed
23.
Zurück zum Zitat Dharnidharka VR, Kwon C, Stevens G (2002) Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis 40:221–226CrossRefPubMed Dharnidharka VR, Kwon C, Stevens G (2002) Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis 40:221–226CrossRefPubMed
24.
Zurück zum Zitat Bachorzewska-Gajewska H, Malyszko J, Sitniewska E et al (2008) NGAL (neutrophil gelatinase-associated lipocalin) and cystatin C: are they good predictors of contrast nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine? Int J Cardiol 127(2):290–291CrossRefPubMed Bachorzewska-Gajewska H, Malyszko J, Sitniewska E et al (2008) NGAL (neutrophil gelatinase-associated lipocalin) and cystatin C: are they good predictors of contrast nephropathy after percutaneous coronary interventions in patients with stable angina and normal serum creatinine? Int J Cardiol 127(2):290–291CrossRefPubMed
25.
Zurück zum Zitat O’Seaghdha CM, Tin A, Yang Q, Katz R, Liu Y, Harris T et al (2014) Association of a cystatin C gene variant with cystatin C levels, CKD, and risk of incident cardiovascular disease and mortality. Am J Kidney Dis 63:16–22CrossRefPubMed O’Seaghdha CM, Tin A, Yang Q, Katz R, Liu Y, Harris T et al (2014) Association of a cystatin C gene variant with cystatin C levels, CKD, and risk of incident cardiovascular disease and mortality. Am J Kidney Dis 63:16–22CrossRefPubMed
Metadaten
Titel
Pentoxifylline for the prevention of contrast-induced nephropathy in diabetic patients undergoing angioplasty: a randomized controlled trial
verfasst von
Naser Aslanabadi
Roghayeh Afsar Gharebagh
Saba Moharramzadeh
Taher Entezari-Maleki
Publikationsdatum
04.03.2019
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 4/2019
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-019-02104-6

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