Effects of pentoxifylline on the haematologic status in anaemic patients with advanced renal failure

Objective: Erythropoietin (EPO) deficiency is the main cause of renal anaem ia. However, inhibition of erythropoiesis by cytokines such as tumour necro sis factor alpha (TNF-a) may play an important role. The aim of this work w as to study the effects of pentoxifylline, an agent with anti-TNF-a propert ies, on the haematologic status in anaemic patients with advanced renal fai lure. 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 haemog lobin, haematocrit, creatinine clearance and serum EPO and TNF-a a concentr ations were compared with those obtained from an untreated control group. R esults: Haemoglobin and haematocrit: significantly increased in the pentoxi fylline-treated patients (9.9 +/- 0.5 g/dl and 27.9 +/- 1.6% at baseline; 1 0.6 +/- 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 rem ained stable in all patients. However, the serum TNF-a concentration decrea sed significantly in patients receiving pentoxifylline (basal 623 +/- 366 p g/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 impro ve the haematologic status in anaemic patients with advanced renal failure.