Abd El Mobdy AH, Hebah HA, Ezzat MA, Eid Mohamed BA, Ahmed FA. Effect of pentoxifylline on inflammatory markers in non-diabetic chronic kidney disease patients: A prospective, interventional, open label. World J Nephrol 2026; 15(3): 120037 [DOI: 10.5527/wjn.120037]
Corresponding Author of This Article
Ashraf Hassan Abd El Mobdy, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Ahmed Fakhry Street, Cairo 31511, Egypt. ashrafnephro@med.asu.edu.eg
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Clinical Neurology
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research-article
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Abd El Mobdy AH, Hebah HA, Ezzat MA, Eid Mohamed BA, Ahmed FA. Effect of pentoxifylline on inflammatory markers in non-diabetic chronic kidney disease patients: A prospective, interventional, open label. World J Nephrol 2026; 15(3): 120037 [DOI: 10.5527/wjn.120037]
World J Nephrol. Sep 25, 2026; 15(3): 120037 Published online Sep 25, 2026. doi: 10.5527/wjn.120037
Effect of pentoxifylline on inflammatory markers in non-diabetic chronic kidney disease patients: A prospective, interventional, open label
Ashraf Hassan Abd El Mobdy, Hayam Ahmed Hebah, Mohammed Ali Ezzat, Basant Abdelkarim Eid Mohamed, Fatma Abdelrahman Ahmed
Ashraf Hassan Abd El Mobdy, Hayam Ahmed Hebah, Mohammed Ali Ezzat, Fatma Abdelrahman Ahmed, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo 31511, Egypt
Basant Abdelkarim Eid Mohamed, Department of Nephrology, Faculty of Medicine, Ain Shams University Hospital, Cairo 11512, Egypt
Author contributions: All authors contributed to the study conception and design; material preparation, data collection and analysis were performed by Hebah HA, Ezzat MA and Abd El Mobdy AH; the first draft of the manuscript was written by Eid Mohamed BA, Ahmed FA; all authors commented on previous versions of the manuscript; all authors read and approved of the final manuscript.
Institutional review board statement: The study was conducted from February 2023 to August 2023, following authorization from the Research Ethics Committee of Ain Shams University, Cairo, Egypt (Approval No. FMASU MS 53/2023).
Clinical trial registration statement: This study was registered at ClinicalTrial.gov (URL: https://clinicaltrials.gov/). The registration identification number is NCT07302464 (date: December 24, 2025).
Informed consent statement: Informed written consent was obtained from all patients.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Data is available on reasonable request from the corresponding author.
Corresponding author: Ashraf Hassan Abd El Mobdy, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Ahmed Fakhry Street, Cairo 31511, Egypt. ashrafnephro@med.asu.edu.eg
Received: February 13, 2026 Revised: April 4, 2026 Accepted: July 2, 2026 Published online: September 25, 2026 Processing time: 181 Days and 15.7 Hours
Abstract
BACKGROUND
Pentoxifylline (PTX), a methylxanthine derivative, has been shown to exert notable anti-inflammatory and antiproteinuric actions in diabetic kidney disease, contributing to improved sodium handling, attenuation of renal hypertrophy, and reductions in tumour necrosis factor-alpha (TNF-α), interleukin-6 levels, and albuminuria.
AIM
To determine the impact of PTX on inflammatory biomarkers and the progression of chronic kidney disease (CKD) in non-diabetic patients.
METHODS
This prospective, interventional, open label, randomized controlled clinical study was conducted on 42 participants aged 18 years or older, of both genders, with CKD stages 3 or 4 and proteinuria < 1 g/24 hours. Participants were placed into two equal groups. Group 1 had standard therapy, including angiotensin-converting enzyme inhibitors (ACEIs; ramipril 1.25 mg), calcium acetate (700 mg), alfacalcidol (0.25 µg), antihypertensives, and diuretics. Group 2 had the same standard therapy plus PTX 400 mg (Trental®) two times per day for six consecutive months.
RESULTS
There was no significant relationship between TNF-α and high-sensitivity C-reactive protein (hs-CRP) and participants’ gender in both groups. An essential direct correlation was observed between TNF-α and creatinine in both groups. A critical direct correlation was observed between hs-CRP and calcium in group B. There was a significant inverse correlation between the change in TNF-α and estimated glomerular filtration rate, as well as between the change in TNF-α and the urinary protein-to-creatinine ratio. The change in protein creatinine ratio noted in group 2 was mainly due to changes in mean arterial pressure, followed by changes in TNF-α.
CONCLUSION
In non-diabetic CKD patients, adjunctive treatment with PTX was associated with significant decreases in C-reactive protein levels and proteinuria. The reduction in proteinuria was mainly explained by changes in mean arterial pressure, followed by changes in TNF-α, indicating that hemodynamic factors may play a more prominent role than inflammatory modulation in mediating this effect.
Core Tip: This randomized controlled study evaluated the effect of pentoxifylline (PTX) on inflammation and disease progression in non-diabetic chronic kidney disease (CKD) stages 3-4. Adding PTX to standard therapy significantly reduced C-reactive protein and proteinuria compared with standard treatment alone. Changes in tumour necrosis factor-alpha were inversely correlated with estimated glomerular filtration rate and urinary protein-to-creatinine ratio, highlighting a link between inflammation and renal function decline. PTX may offer additional anti-inflammatory and renoprotective benefits in non-diabetic CKD.
