Effect of pentoxifylline on proteinuria of diabetic nephropathy in comparison with captopril in type II diabetic patients

Diabetic nephropathy is the most common cause of ESRD. Proteinuria has an important role in rapid progression to ESRD. Pentoxifylline (PTX) is a drug with TNF-α suppression effect and hence reduction of proteinuria and slowing of progression of diabetic nephropathy. To evaluate this hypothesis of PTX effect in comparison with captopril, we studied 40 type 2 diabetics with macroproteinuria (> 300 mg/day), who had no contraindication for PTX and didn’t take PTX or ACEI for the past year. We didn’t change the profile of diabetes or HTN drugs of our patients. We planned a cross over study in two 2-month periods of PTX or captoril therapy spaced with a one-month washout period. At beginning and the end of each treatment period we measured blood pressure, FBS, creatinine and 24-hour urine collection for volume, creatinine and protein. PTX reduced proteinuria by 0.44±0.63g/day in comparison with 0.1±0.22g/day with captoprial (P = 0.008). In conclusion PTX is superior than captopril in reducing proteinuria in type 2 diabetic patients.