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Published on: March 29, 2024

Pentoxifylline and cardiorenal outcomes in advanced CKD with untreated dyslipidemia: a longitudinal cohort study

Yi-Chih Lin1,2,3, Tai-Shuan Lai2,3, Yu-Hsiang Chou2,3

  • 1Department of Medicine, National Taiwan University Hospital Jinshan Branch, Taipei, Taiwan.

Renal Failure
|July 2, 2026
PubMed

Insights

Pentoxifylline (PTX) may reduce kidney failure risk in advanced chronic kidney disease (CKD) patients with dyslipidemia. While associated with fewer cardiovascular events, further research is needed for confirmation.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Advanced chronic kidney disease (CKD) and dyslipidemia increase risks for kidney failure and cardiovascular events.
  • Many patients with advanced CKD and dyslipidemia do not receive lipid-lowering therapy.
  • Pentoxifylline (PTX), with anti-inflammatory and antifibrotic properties, has an uncertain role in cardiorenal outcomes.

Purpose of the Study:

  • To investigate the association between pentoxifylline (PTX) use and hard cardiorenal outcomes in patients with advanced CKD and untreated dyslipidemia.
  • To evaluate PTX's effect on progression to end-stage kidney disease (ESKD) and major adverse cardiovascular events (MACE).

Main Methods:

  • Retrospective cohort study of adults with stage 3b-5 CKD and dyslipidemia (2007-2018).
  • Exclusion of patients on lipid-lowering therapy; 1:1 propensity score matching for PTX initiators and nonusers.
  • Primary outcome: progression to ESKD. Secondary outcomes: MACE, 50% eGFR decline, creatinine doubling. Sensitivity analyses performed.

Main Results:

  • Propensity score matching included 2,776 patients; PTX use was linked to reduced ESKD risk (HR 0.85, 95% CI 0.75-0.96).
  • PTX use was also associated with a lower risk of MACE (HR 0.80, 95% CI 0.65-0.98).
  • No significant associations found for short-term kidney function decline or creatinine doubling; sensitivity analyses did not indicate harm.

Conclusions:

  • Pentoxifylline (PTX) use is associated with a decreased risk of kidney failure in advanced CKD patients with untreated dyslipidemia.
  • The association between PTX and cardiovascular events was less consistent after sensitivity analyses.
  • Findings require cautious interpretation and further validation in prospective studies.
Abstract

Keywords:
Pentoxifyllinechronic kidney diseasedyslipidemiaend-stage kidney diseasemajor adverse cardiovascular events

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