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Meta-Analysis
. 2017 Apr;45(2):383-398.
doi: 10.1177/0300060516663094. Epub 2017 Jan 1.

Pentoxifylline plus ACEIs/ARBs for proteinuria and kidney function in chronic kidney disease: a meta-analysis

Dong Liu  1 , Li-Na Wang  2 , Hong-Xia Li  1 , Ping Huang  3 , Liang-Bo Qu  3 , Fei-Yan Chen  3
Affiliations
Meta-Analysis

Pentoxifylline plus ACEIs/ARBs for proteinuria and kidney function in chronic kidney disease: a meta-analysis

Dong Liu et al. J Int Med Res. 2017 Apr.

Abstract

Objective This meta-analysis aimed to investigate the efficacy and safety of pentoxifylline (PTF) plus angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) for proteinuria and kidney function in chronic kidney disease (CKD). Methods CENTRAL, EMBASE, Ovid-MEDLINE, PubMed, and CNKI were searched for relevant, randomized, controlled trials (RCTs). A meta-analysis was performed to review the effect of PTF plus ACEIs/ARBs vs. ACEIs/ARBs alone on proteinuria and kidney function in CKD. Results Eleven RCTs including 705 patients were retrieved. PTF plus ACEI/ARB treatment significantly decreased proteinuria in patients with CKD within 6 months (standard mean difference [SMD] -0.52; 95% CI -0.90 to 0.15; I2 = 68%) and significantly attenuated a decrease in estimated glomerular filtration rate (eGFR) in patients with stages 3-5 CKD after 6 months of treatment (standard mean difference [SMD] 0.30; confidence limit [Cl] 95% CI 0.06 to 0.54; I2 = 0%). PTF plus ACEIs/ARBs for 9 to 12 months significantly reduced albuminuria in patients with CKD (SMD-0.30, 95% CI -0.57 to 0.03; I2 = 0%) and alleviated the decline in eGFR in patients with stages 3-5 CKD (SMD 0.51; 95% CI 0.06 to 0.96; I2 = 61%). Conclusion The combination of an ACEI or ARB and PTF has a protective effect in reducing proteinuria by ameliorating the decline in eGFR in patients with stages 3-5 CKD.

Keywords: ACEI/ARB; Pentoxifylline; chronic kidney disease; meta-analysis.

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Figures

Figure 1.
Figure 1.
Flowchart of the literature search.
Figure 2.
Figure 2.
Risk of bias graph according to recommendations from the Cochrane collaboration.
Figure 3.
Figure 3.
Effects of PTF + ACEI/ARB vs. ACEI/ARB treatment within 6 months on proteinuria, serum creatinine levels, creatinine clearance, and eGFR in patients with CKD.
Figure 4.
Figure 4.
Effects of PTF + ACEI/ARB vs. ACEI/ARB treatment within 6 months on proteinuria in patients with CKD.
Figure 5.
Figure 5.
Effects of PTF plus ACEI/ARB vs. ACEI/ARB treatment for 9 to 12 months on albuminuria, serum creatinine levels, and eGFR in patients with CKD.
See this image and copyright information in PMC

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