Pentoxifylline Therapy in Idiopathic Membranous Nephropathy
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- Category: Vol. 79, June 2011
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Pentoxifylline Therapy in Idiopathic Membranous Nephropathy,DAWLAT A. BELAL, TAREK M.S. FAYAD, HODA EL-RAWI, NOHA MOHAMED and HODA MAMOON
Abstract
Idiopathic membranous nephropathy is the most common from of nephrotic syndrome in adults. The immune-mediated glomerular injury in membranous nephropathy is associated with increased production of tumor necrosis factor alpha (TNF-a) which play a contributory role.
This study aimed to explore the role of pentoxifylline therapy on the level of tumor necrosis factor alpha (TNF-a) in idiopathic membranous nephropathy.
Results: 20 patients and 10 control subjects were chosen and divided into 3 groups. Group 1: 10 membranous nephr-opathy patients received pentoxifylin. Group 2: 10 membranous nephropathy patients without pentoxifyllin. Group (3): Control group. We exclude secondary MN and patients with sever MN in the form of impaired renal functions, sever hypertension or heavy protienurea >8gm/24 hours. It was found that urinary and serum TNF-alpha levels befor treatment were higher in the study group (1.5350) and (1.080) respectively than in the control group (0.20) and (0.225). p-value <0.001 (Table 2).
After 3 months of treatment with pentoxifylline there was improvement of urinary and serum TNF-a levels in group (I) p-value=0.007 and 0.005 respectively. It also showed signif-icant reduction in 24 hours urinary proteins level from (4.48) before treatment to (1.10) after 3 months treatment p-value 0.005. On the otherhand the levels serum TNF-a in group (II) show no statistically sig differences (0.92) to (1.40) p-value 0.721 with improvement of 24h urinary proteins with p-value 0.005. There was no statistical difference between group I and II 3 months after treatment as regarding both urinary and serum TNFa, p-value >0.05.
There was statistically sig differences in both serum and urinary TNF-alpha in the studied groups before and 3 months after treatment with p-value 0.021, 0.001 respectivly. But serum level of TNF- alpha was higher after the treatment.
We found that 24 urinary proteins were positively corre-lated with urinary TNF-a (r=0.443 -p-value 0.05), but was not sig correlated to serum TNFa (r 0.324 -p 0.164).
Conclusion: We concluded that TNF-a is high in patients with idiopathic membranous nephropathy, and we found that pentoxifylline has a beneficial effect in patients with idiopathic membranous nephropathy in lowering 24h urinary protein and urinary TNF-alpha.