The effect of pentoxifylline on the glomerular functionin patients with severe pre-eclampsia

Introduction Pentoxifylline (PTX) is a phosphodiesterase inhibitor that directly upregulates the expression of vascular endothelial growth factor mRNA. Pre-eclampsia (PE) is a pregnancy-specific vascular endothelial disorder with a characteristic glomerular lesion, glomerular endotheliosis, that is due to vascular endothelial growth factor deprivation. This study aimed to investigate the effect of PTX on the functional manifestations of the glomerular endothelial injury in patients with severe PE. Patients and methods Forty patients with severe PE admitted to the Ain Shams Obstetric ICU were assigned randomly in the immediate postpartum period to one of two groups (20 in each group): the PTX group received a continuous intravenous infusion of PTX 400 mg every 8 h daily for 3 days; the control group received normal saline solution as placebo every 8 h daily for 3 days. The primary endpoint was the improvement of renal assessment data in the form of the serum creatinine level, the urine protein/creatinine (P/C) ratio, and urine nephrin levels.ResultsPTX administration in patients with severe PE was associated with significant reduction of urinary nephrin compared with baseline values (day 1) as well as with the values on day 3 in the control group (P = 0.007 and P 0.001, respectively). Further, administrating PTX showed significant reduction of the urine P/C ratio and serum creatinine levels. Acute kidney injury developed overall in 10 and 40% of the patients in the PTX group and the control group, respectively. ConclusionThe current study demonstrates that PTX administration to patients with severe PE, as anadditional treatment to standard therapy on admission to the ICU, exhibits a renoprotective effect.