Effects of Pentoxifylline on the Haematologic Status in Anaemic Patients with Advanced Renal Failure

Objective: Erythropoietin (EPO) deficiency is the main cause of renal anaemia. However, inhibition of erythropoiesis by cytokines such as tumour necrosis factor alpha (TNF-a) may play an important role. The aim of this work was to study the effects of pentoxifylline, an agent with anti-TNF-a properties, on the haematologic status in anaemic patients with advanced renal failure. Material and Methods: In a prospective study, 7 anaemic patients with advanced renal disease (creatinine clearance <30 ml/min) were treated with pentoxifylline (400 mg orally daily) for 6 months. The evolution of haemoglobin, haematocrit, creatinine clearance and serum EPO and TNF-a a concentrations were compared with those obtained from an untreated control group. Results: Haemoglobin and haematocrit significantly increased in the pentoxifylline-treated patients (9.9 ± 0.5 g/dl and 27.9 ± 1.6% at baseline; 10.6 ± 0.6 g/dl and 31.3 ± 1.9% at the 6th month, respectively, p < 0.01), whereas no variation was seen in the control group. Serum EPO levels remained stable in all patients. However, the serum TNF-a concentration decreased significantly in patients receiving pentoxifylline (basal 623 ± 366 pg/ml; 6th month 562 ± 358 pg/ml, p < 0.01), but not in the control group. Conclusions: Our findings suggest that the inhibition of erythropoiesis by cytokines may play a significant role in renal anaemia. The administration of agents with anti-cytokine properties, such as pentoxifylline, can improve the haematologic status in anaemic patients with advanced renal failure.