The Effects of Oral Pentoxifylline on the Prevention of Contrast-Induced Nephropathy in Patients with Chronic Kidney Disease and Normal Renal Function: A Randomized Clinical Trial Pentoxifylline Effects on Contrast-Induced Nephropathy
International Pharmacy Acta,
Vol. 4 No. 1 (2021),
2 June 2021
Introduction: Finding preventive methods for Contrast-Induced Nephropathy (CIN) is essential for reducing the burden of complications. In this context, anti-oxidant agents such as pentoxifylline can be viable options. This study aimed to determine the effects of oral pentoxifylline on the prevention of contrast induced nephropathy in patients undergoing angiography.
Methods and Results: In this randomized clinical trial 96 patients with chronic kidney disease (CKD) and 96 subjects with normal renal function were included and randomly assigned to receive either pentoxifylline or placebo. The Incidence of CIN was determined and compared between the groups. The incidence of CIN in healthy subjects receiving pentoxifylline or placebo was 4 (8.3%) and 2 (4.16%), respectively. (P-value = 1). The incidence of CIN in patients with CKD in the pentoxifylline and placebo group was 5 (10.41%) and 12 (25%) respectively. (P-value = 0.58).
Conclusion: According to the obtained results, there was no difference between patients with CKD and those with normal renal function in terms of the pentoxifylline effects on the prevention of Contrast Induced Nephropathy.
- Contrast-Induced Nephropathy
How to Cite
Caixeta A, Mehran R. Evidence-based management of patients undergoing PCI: contrast-induced acute kidney injury. Catheter Cardiovasc Interv 2010; 75: S15-20.
Narula A, Mehran R, Weisz G, Dangas GD, Yu J, Ge´ne´reux P, et al. Contrast-induced acute kidney injury after primary percutaneous coro- nary intervention: results from the HORIZONS-AMI substudy. Eur Heart J 2014; 35:1533-40.
McCullough PA, Adam A, Becker CR, Davidson C, Lameire N, Stacul F, et al. CIN Consensus Working Panel. Epidemiology and prognostic implications of contrast-induced nephropathy. Am J Cardiol 2006;98: 5K-13K.
Shaker OG, El-Shehaby A, El-Khatib M. Early diagnostic markers for contrast nephropathy in patients undergoing coronary angiography. Angiology 2010; 61(8):731-73.
Ahmed K, McVeigh T, Cerneviciute R, et al. Effectiveness of contrast-associated acute kidney injury prevention methods; a systematic review and network meta-analysis. BMC Nephrol. 2018 Nov 13;19(1):323.
Koda-kimble MA, Young, L.Y. Applied Therapeutics The clinical use of Drugs, 7th edition, USA 2001: 23-29.
Lasser EC. Contrast media for urography: In Pollach HM, ed. Clinical urography: An atlas and text book of Urological Imaging, Vol 1. philalelphia, pa: WB Saunders Co; 1990: 23-36.
Moore RD, Steinberg EP, Powe NR. Nephrotoxicity of high osmolality versus low-osmolality contrast media:randomized clinical trial. Radiology 1992; 189:649-55.
Parfery PS, Griffiths SM, Barrett BJ. Contrast material-induced renal failure in patient with diabetes mellitus, renal insufficiency, or both: a prospective controlled study. Negl J Med 1989; 320:143-9.
Pappy R, Stavrakis S, Hennebry TA, Abu-Fadel MS. Effect of statin therapy on contrast-induced nephropathy after coronary angiography: a meta-analysis. Int J Cardiol. 2011;151(3):348-53
Parfrey PS, Griffiths SM, Barrett BJ, et al. Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both. A prospective controlled study. N Engl J Med 1989; 320:143.
Rudnick MR, Goldfarb S, Wexler L, et al. Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a randomized trial. The Iohexol Cooperative Study. Kidney Int 1995; 47:254.
Davidson CJ, Hlatky M, Morris KG, et al. Cardiovascular and renal toxicity of a nonionic radiographic contrast agent after cardiac catheterization. A prospective trial. Ann Intern Med 1989; 110:119.
Schwab SJ, Hlatky MA, Pieper KS, et al. Contrast nephrotoxicity: a randomized controlled trial of a nonionic and an ionic radiographic contrast agent. N Engl J Med 1989; 320:149.
Cigarroa RG, Lange RA, Williams RH, Hillis LD. Dosing of contrast material to prevent contrast nephropathy in patients with renal disease. Am J Med 1989; 86:649.
Lautin EM, Freeman NJ, Schoenfeld AH, et al. Radiocontrast-associated renal dysfunction: incidence and risk factors. Am J Roentgenol 1991; 157:49.
Marenzi G, Lauri G, Assanelli E, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol. 2004;44(9):1780-5.
McCullough PA, Wolyn R, Rocher LL, Levin RN, O’Neill WW. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med. 1997;103(5):368-75.
Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ. 2005;172(11):1461-71.
Akcay A, Nguyen Q, Edelstein CL. Mediators of inflammation in acute kidney injury. Mediators Inflamm. 2009; 2009:137072.
Roozbeh J, Jahromi AH, Sharifian M, Pakfetrat M, Afsharinia R. Protective effect of pentoxifylline on contrast induced nephropathy. Saudi Journal of Kidney Disease And Transplantation.2008; 985-6
Tintinalli JE. Tintinalli’s emergency medicine: a comprehensive study guide. 7th edition. 2011
Firouzi A; Eshraghi A; Shakerian F; Sanati HR; Salehi N; Zahedmehr A et al. Efficacy of pentoxifylline in prevention of contrast-induced nephropathy in angioplasty patients. Int Urol Nephrol. 2012; 44(4):1145-9
Busch SV, Jensen SE, Rosenberg J, Gögenur I J Interv Cardiol. Prevention of contrast-induced nephropathy in STEMI patients undergoing primary percutaneous coronary intervention: a systematic review. J Interv Cardiol. 2013; 26(1):97-105.
Eshraghi A, Naranji-Sani R. Pentoxifylline and prevention of contrast-induced nephropathy: Is it efficient in patients with myocardial infarction undergoing coronary angioplasty? ARYA Atheroscler. 2016; 12(5): 238-42.
Yang SK, Duan SB, Pan P, Xu XQ, Liu N, Xu J. Preventive effect of pentoxifylline on contrast-induced acute kidney injury in hypercholesterolemic rats. Exp Ther Med. 2015; 9(2):384-8.
Yavari V, Ostovan MA, Kojuri J, et al. The preventive effect of pentoxifylline on contrast-induced nephropathy: a randomized clinical trial. Int Urol Nephrol. 2014; 46(1):41-6.
Chen YM, Chiang WC, Lin SL, and Tsai TJ. Therapeutic efficacy of pentoxifylline on proteinuria and renal progression: an update. Journal of Biomedical Science 2017; 24:84.
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