Effect of Add-on Pentoxifylline on Proteinuria in Membranous Glomerulonephritis: A 6-month Placebo-controlled Trial

Background Membranous glomerulonephritis (MGN) may cause proteinuria as the main complication and is a strong risk factor for end-stage renal disease. Current therapeutic regimens provide only partial renoprotection. Data derived from both animal and human studies provide a scientific basis for the use of pentoxifylline as an antiproteinuric agent. Objective This study was designed to evaluate the antiproteinuric effect of add-on pentoxifylline therapy in nondiabetic patients with MGN. Study Design This was a double-blind, placebo-controlled trial. Setting Non-diabetic patients with histologically proven MGN and urinary protein excretion (UPE) >500 mg/24 h, entered a 6-month study period. Enrolled patients were selected from a university and three private clinics. Intervention Patients were assigned to one of the two treatment groups: pentoxifylline 400 mg two or three times a day, or matching placebo. Main Outcome Measures Baseline and follow-up assessments included estimated glomerular filtration rate (eGFR) and UPE. Differences in the changes in variables within the placebo and pentoxifylline treatment groups during the study period were assessed using Friedman's test. Results Treatment with pentoxifylline for 6 months resulted in a significant reduction of mean UPE (p < 0.001) along with a slight, non-significant increase of eGFR, in comparison to the mean UPE and eGFR increase in the placebo group. Conclusion This study showed that add-on therapy of pentoxifylline in MGN was beneficial, and could be considered as a potential new therapeutic indication for the drug in such kidney diseases.