Pentoxifylline for chronic kidney disease in people with diabetes: a meta-analysis of randomized trials

Clicks: 4
ID: 333531
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #144 of 146 articles by views in nephrology dialysis transplantation

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 146 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background and hypothesis Pentoxifylline is an inexpensive anti-inflammatory agent tested in diabetic kidney disease for four decades; prior meta-analyses report reduced albuminuria. Whether it is secure, extends to kidney function, or reaches hard outcomes is unclear; we hypothesized the surrogate evidence might be conclusive and the hard-outcome evidence not. Methods We reviewed randomized trials of oral pentoxifylline in diabetic kidney disease to June 2026, without language restriction. Co-primary surrogate outcomes were albuminuria (ratio of means) and glomerular filtration rate (GFR) change (mean difference); the primary hard outcome was end-stage kidney disease or death (risk ratio). We pooled with random-effects models, assessed risk of bias with RoB 2, and report a prediction interval and trial sequential analysis with every estimate. Results Thirty-four studies were included, 32 contributing data. Albuminuria fell by about a third (ratio of means 0.69, 95% CI 0.50–0.94; 22 studies contributing 23 comparisons), but heterogeneity was extreme (I2 97%), the prediction interval 0.15–3.10, and only 53% of the required information had accrued, with no boundary crossed. Over ≥ 12 months, GFR changed 4.49 mL/min/1.73 m2 more favorably with pentoxifylline than with control (0.84–8.14; 5 studies contributing 5 comparisons); in two trials at low or some-concerns risk of bias it was 2.96 (-15.34 to 21.26), with 11% of the required information accrued. For end-stage kidney disease or death, 29 events in 6 studies contributing 7 comparisons gave a risk ratio of 0.90 (0.46–1.77), 3% of that required. Gastrointestinal adverse events were three times as common (3.00, 1.94–4.64); serious ones were not (0.83, 0.56–1.22). Conclusions Pentoxifylline reduces albuminuria, but the effect is heterogeneous, depends on which trials are counted, and may not reappear in a new trial. Kidney failure and death have scarcely been tested. The priority is an adequately powered, long-term trial reporting hard endpoints; gastrointestinal intolerance should be anticipated.
Reference Key
openalex_W7223245665 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Rajiv Agarwal, David J. Leehey, Sankar Dass Navaneethan, Kristina M. Utzschneider, 邢斌, Kimberly Carlson
Journal nephrology dialysis transplantation
Year 2026
DOI
10.1093/ndt/gfag244
URL
https://doi.org/10.1093/ndt/gfag244
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.