The adverse events of pentoxifylline were mild; no serious adverse events were reported in any of the included studies.
Pentoxifylline seemed to have some beneficial effects in improving kidney function and reducing albuminuria and proteinuria (which can indicate kidney health) for patients with DKD, and was not associated with any major adverse effects.
Evidence to support the use of pentoxifylline for DKD was insufficient to develop recommendations for its use in this patient population.
Rigorously designed, randomised, multicentre, large scale studies of pentoxifylline for DKD are needed to further assess its therapeutic effects.
Selection criteria: All randomised controlled trials (RCTs) and quasi‐RCTs studying the benefits and harms of pentoxifylline for DKD.
Data collection and analysis: Data were extracted independently by two authors.
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We reviewed 17 randomised controlled studies, enrolling 991 patients with DKD, which compared pentoxifylline with placebo, routine treatment or antihypertensive drugs.
Compared with placebo, pentoxifylline significantly reduced serum creatinine (SCr), albuminuria, and overt proteinuria, but not creatinine clearance (Cr Cl).
Kidney disease develops in 25% to 40% of diabetic patients, usually 20 to 25 years after the onset of diabetes.
Approximately one third of those with diabetic kidney disease (DKD) will progress to end stage kidney disease (ESKD) and will require long‐term dialysis or possibly receive a kidney transplant.