The effect of pentoxifylline on oxidative stress in chronic kidney disease patients with erythropoiesis stimulating agent hyporesponsiveness: Sub study of the HERO trial
Objective: Pentoxifylline has previously been shown to increase haemoglobin levels in patients with chronic kidney disease (CKD) and erythropoietin stimulating agent (ESA) hyporesponsive anaemia in the HERO multi centre double blind, randomized controlled trial. The present study evaluated the effects of pentoxifylline on oxidative stress in ESA hyporesponsive CKD patients. Methods: This sub study of the HERO trial compared 15 patients in the pentoxifylline arm (400 mg daily) and 17 in the matched placebo arm on oxidative stress markers: plasma total F2 isoprostanes, protein carbonyls, glutathione peroxidase (GPX) and superoxide dismutase (SOD) activities. Results: Pentoxifylline did not significantly alter total F2 isoprostanes (adjusted mean difference (MD) 35.01 pg/ml, P 0.11) SOD activity (MD 0.82 U/ml, P 0.07) GPX activity (MD 6.06 U/l, P 0.09) or protein carbonyls (MD 0.04 nmol/mg, P 0.52) Replicating results from the main study, pentoxifylline significantly increased haemoglobin concentration compared with controls (MD 7.2 g/l, P 0.04) Conclusions: Pentoxifylline did not alter oxidative stress biomarkers, suggesting that alternative mechanisms may be responsible for the agent's ability to augment haemoglobin levels in CKD patients with ESA hyporesponsive anaemia.
Redox report communications in free radical research