The efficacy and safety of pentoxifylline in the treatment of chronic kidney disease: a systematic review and meta-analysis.

PURPOSE: This research sought to systematically evaluate the effects of pentoxifylline on renal function, anemia parameters, inflammatory status, and safety among individuals with chronic kidney disease (CKD).

METHODS

PubMed, Embase, Cochrane Library, and Web of Science were searched up to April 9, 2026 for RCTs of pentoxifylline in CKD. Two reviewers independently performed study selection, data extraction, and quality assessment. Meta-analysis was conducted using Stata 15; continuous outcomes were pooled as MD or SMD with 95% CIs. Heterogeneity was evaluated using the I² statistic.

RESULTS

In total, 19 studies involving 1166 patients were included. Meta-analysis showed that, compared to the control group, pentoxifylline significantly increased the estimated glomerular filtration rate (7 studies, N = 547, MD = 4.59 mL/min/1.73 m², 95% CI: 2.57-6.61) and reduced the urinary albumin excretion rate (6 studies, N = 494, SMD = -0.57, 95% CI: -1.01--0.12), C-reactive protein (10 studies, N = 594, SMD = -0.70, 95% CI: -1.08--0.31), and tumor necrosis factor-α levels (5 studies, N = 246, SMD = -0.68, 95% CI: -1.19--0.18). Regarding anemia and nutritional indicators, pentoxifylline increased hemoglobin levels (9 studies, N = 424, SMD = 0.51, 95% CI: 0.08-0.94) and potentially improved serum albumin levels (7 studies, N = 355, MD = 0.19 g/dl ,95% CI: 0.00-0.38). Nevertheless, the effects of pentoxifylline on serum ferritin, transferrin saturation, and urinary albumin-to-creatinine ratio were not significant. Regarding safety, the main adverse events included gastrointestinal symptoms, and overall tolerability appeared promising.

CONCLUSION

In patients with CKD, pentoxifylline safely improves renal function and reduces inflammation and anemia, with its efficacy potentially linked to the dosage and duration of treatment.