[Pentoxifylline old drug or new hope for nephrology?]

Pharmacological inhibition of the renin-angiotensin-aldosteron system (RAAS) constitutes a cornerstone strategy in the management of patients with chronic nephropathies with proteinuria and with chronic renal failure. Angiotensin converting enzyme inhibitors (ACEI) as well as angiotensin II subtype 1 receptor antagonists have been shown to decrease proteinuria, reduce the local renal inflammatory processes and slow the progression of renal insufficiency. Despite recent progress, there is still no optimal therapy that would stop progression of renal disease. May be pentoxifilline (PTF)--the old medication which is still used to treat peripheral vascular disease and brain ischemia will be the new adjunct to RAAS blockade. In addition, PTF has been shown to decrease the production of pro-inflammatory cytokines and reactive oxygen species. PTF therapy may improve the hemoglobin response in patients with previously rh-EPO resistant anemia in renal failure. This may occur due to inhibition of proinflammatory cytokine production. Probably in the next few years we will get answer to the question of PTF role in nephrology.