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The effect of a methylxanthine vasodilator: pentoxifylline on the treatment of diabetic nephropathy—a meta-analysis

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Abstract

This meta-analysis aimed to comprehensively evaluate the efficacy and safety of pentoxifylline (PTF) in the treatment of diabetic nephropathy (DN) and to offer fresh perspectives and evidence-based references for this condition. Meta-analysis. Relevant randomized controlled trials (RCTs) were searched from PubMed, Embase, Cochrane Library, China Knowledge Network (CNKI), Wanfang, and China Biomedical Literature Database. All trials were screened for compliance with the inclusion and exclusion criteria, and relevant data were extracted after quality evaluation. Eighteen studies with a total of 1280 patients were finally included. Compared to the control group, high sensitivity C-reactive protein (hsCRP) was improved (MD = − 0.23. 95% CI = [− 0.41, − 0.05], P = 0.01); urinary albumin excretion (UAE) rate was reduced (MD = − 16.50, 95% CI = [− 18.87, − 14.13], P<0.00001); the change of serum creatinine (Scr) from baseline was reduced (MD = − 0.05, 95%CI = [− 0.08, − 0.01], P = 0.009); fasting plasma glucose (FPG) was decreased (MD = − 5.66, 95% CI = [− 9.79, − 1.53], P = 0.007); and the improvement of glomerular filtration rate (eGFR) from baseline was increased (MD = 4.38, 95% CI = [3.28, 5.48], P<0.00001) in the treatment group. No significant difference was observed between the two groups concerning systolic blood pressure, diastolic blood pressure, total cholesterol, and triglycerides. And in terms of safety, the use of PTF was relatively safe with some self-limiting adverse events. FPG was decreased by PTF more effectively, but there was no effect of PTF on glycated hemoglobin (HbA1c). PTF could improve hsCRP, decrease UAE and Scr, and raise eGFR in the treatment of DN.

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Funding

This study was supported by grants from the Natural Science Foundation of China (No.81870505, No.82270778) and the program for Shenyang Bureau of Science and Technology (No.21-173-9-50).

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Authors and Affiliations

  1. Department of Nephrology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning Province, People’s Republic of China

    Mingyu Zhang, Yaqing Wang, Wenjing Fu & Li Sun

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  1. Mingyu Zhang
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MYZ wrote the main manuscript text and prepared figures 14-15 and YQW and WJF prepared figures 1-13. All authors reviewed the manuscript. The authors confirm that no paper mill and artificial intelligence was used.

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Correspondence to Li Sun.

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Zhang, M., Wang, Y., Fu, W. et al. The effect of a methylxanthine vasodilator: pentoxifylline on the treatment of diabetic nephropathy—a meta-analysis. Naunyn-Schmiedeberg's Arch Pharmacol 397, 2777–2791 (2024). https://doi.org/10.1007/s00210-023-02842-6

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