The effect of pentoxifylline on oxidative stress in chronic kidney disease patients with erythropoiesis-stimulating agent hyporesponsiveness: Sub-study of the HERO trial

L Zhang, J Coombes, Elaine Pascoe, V Badve Sunil, Dalziel Kim, Alan Cass, P Clarke, Paolo Ferrari, Stephen McDonald, Alicia Morrish, Eugenie Pedagogos, Vlado Perkovic, Donna Reidlinger, Anish Scaria, Rowan Walker, Liza Vergara, Carmel Hawley, David Johnson

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    Abstract

    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.
    Original languageEnglish
    Pages (from-to)14-23
    Number of pages10
    JournalRedox Report
    Volume21
    Issue number1
    DOIs
    Publication statusPublished - 2016

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    Zhang, L., Coombes, J., Pascoe, E., Sunil, V. B., Kim, D., Cass, A., Clarke, P., Ferrari, P., McDonald, S., Morrish, A., Pedagogos, E., Perkovic, V., Reidlinger, D., Scaria, A., Walker, R., Vergara, L., Hawley, C., & Johnson, D. (2016). The effect of pentoxifylline on oxidative stress in chronic kidney disease patients with erythropoiesis-stimulating agent hyporesponsiveness: Sub-study of the HERO trial. Redox Report, 21(1), 14-23. https://doi.org/10.1179/1351000215Y.0000000022