Resumo

MORA-GUTIERREZ, José M.; FERRER-NADAL, Asunción  e  GARCIA-FERNANDEZ, Nuria. Effect of pentoxifylline on anaemia control in haemodialysis patients: retrospective observational case-control study. Nefrología (Madr.) [online]. 2013, vol.33, n.4, pp.524-531. ISSN 1989-2284.  https://dx.doi.org/10.3265/Nefrologia.pre2013.Apr.11654.

Introduction and objectives: Treatment with iron and erythropoiesis-stimulating agent (ESA) does not lead to optimal control of anaemia in some hemodialysis patients, which has been associated with inflammation. Pentoxifylline (PTX) may provide benefits in these cases due to its antiinflammatory properties. We studied the possible effect of PTX on anaemia control in hemodialysis patients. Patients and Method: Retrospective observational case-control study including 18 cases (treated with PTX) and 18 controls (without PTX matched by age and gender) in HD (Clínica Universidad de Navarra). Four patients received PTX due to vasculopathy and 14 patients due to resistent anaemia (which was defined as hemoglobin (Hb) <11g/dL in the last three months despite high doses of ESA and transferrin saturation of >20%). Hb, MIRCERA^® dose and C-reactive protein were registered at baseline (before starting PTX treatment), after 3 months and at the end of the study. Results: Patients receiving PTX had higher Hb levels (p<0.001) in the third month and lower ESA requirements at the end of the follow-up (p=0.002). The baseline differences between groups in terms of Hb levels (lowest of all cases) (p<0.001) and ESA dosage (highest of all cases) (p=0.006), disappeared at 3 months. At the end of the study, 11 of 18 (61,1%) treated patients with PTX maintained adequate Hb levels and received doses of ESA comparable with those of controls. Conclusions: In HD patients, PTX treatment (800mg per day) improves hemoglobin levels (~61% response) in the short-term (3 months) and reduces the required ESA dose in the long term. This effect is sustained over time and does not entail any side effects.

Palavras-chave : Haemodialysis; Anaemia; Pentoxifylline; Inflammation.

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