Clinical Study Effect of Pentoxifylline on Microalbuminuria in Diabetic Patients: A Randomized Controlled Trial Shahrzad Shahidi, 1 Marziyeh Hoseinbalam, 2 Bijan Iraj, 2 and Mojtaba Akbari 3 1 Isfahan Kidney Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2 Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 3 Department of Epidemiology, School of Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran Correspondence should be addressed to Marziyeh Hoseinbalam; drhoseinbalam@yahoo.com Received 23 September 2014; Revised 22 January 2015; Accepted 8 February 2015 Academic Editor: Jochen Reiser Copyright © 2015 Shahrzad Shahidi et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Pentoxifylline is a nonspeciic phosphodiesterase inhibitor with anti-inlammatory properties. Human studies have proved its antiproteinuric efect in patients with glomerular diseases, but this study was designed to assess the efects of add-on pentoxifylline to available treatment on reduction of microalbuminuria in diabetic patients without glomerular diseases. Methods. In a double-blind placebo-controlled, randomized study we evaluated the inluence of pentoxifylline on microalbuminuria in type 2 diabetic patients. 40 diabetic patients with estimated glomerular iltration rate (eGFR) of more than 60 mL/min/1.73 m 2 in eight weeks and microalbuminuria were randomized to two groups which will receive pentoxifylline 1200mg/day or placebo added to regular medications for 6 months. albuminuria; eGFR was evaluated at three- and six-month follow-up period. Results. Baseline characteristics were similar between the two groups. At six months, the mean estimated GFR and albuminuria were not diferent between two groups at 3- and 6-month follow-up. Trend of albumin to creatinine ratio, systolic and diastolic blood pressure, and eGFR in both groups were decreased, but no signiicant diferences were noted between two groups ( value > 0.05). Conclusion. Pentoxifylline has not a signiicant additive antimicroalbuminuric efect compared with placebo in patients with type 2 diabetes with early stage of kidney disease; however, further clinical investigations are necessary to be done. 1. Introduction Diabetes is among the most common and major diseases in the world and recently in most countries the number of patients with diabetes has strikingly increased. Diabetic nephropathy is enlisted as one of the chronic microvascular complications of diabetes which is associated with consider- able morbidity and mortality [1, 2] and is a main cause for approximately 50% of all end stage renal disease, and this results in increasing renal replacement therapy and health- care costs [3, 4]. hough many pathophysiologic processes are involved in the pathogenesis of diabetic nephropathy, the fundamental mechanisms of it are not fully established [5]. Diabetic nephropathy is characterized by proteinuria, hypertension, and advanced renal insuiciency. More than 350 million people will be alicted by diabetes by 2030 [6]; and about 20 to 30 percent of these diabetic patients, either type 1 or type 2, will be sufering from diabetic nephropathy, which has a greater incidence as the disease becomes more chronic [7]. Recently, the focus has moved to much earlier stages in renal disease as established by the presence of microalbumin- uria [8, 9] and this is an early sign of diabetic nephropathy and premature cardiovascular disease [9, 10]. Biannual control of microalbuminuria in patients with diabetes is recommended in American and European guidelines [11, 12]. Microalbumin- uria indicates a possibility of ongoing renal involvement due to diabetic nephropathy which ultimately results in end stage renal disease [13]. In type 2 diabetes, microalbuminuria or overt proteinuria may be present by the time of diagnosis and the latter is oten accompanied by hypertension in these patients; however conditions such as congestive heart failure, hypertension, and infections can also lead to microal- buminuria in diabetic patients [2, 14]. It is reported that Hindawi Publishing Corporation International Journal of Nephrology Volume 2015, Article ID 259592, 7 pages http://dx.doi.org/10.1155/2015/259592