Hemodialysis membrane-related neutrophil dysfunctions and pentoxifylline - a pilot study

Hemodialysis treatment is associated with activation of neutrophil
granulocytes. Pentoxifylline has been shown to inhibit neutrophil
activation in vitro and in vivo. We investigated the effect of
pentoxifylline on leukocyte and platelet counts and on plasma
levels of extracellularly released neutrophil elastase and
lactoferrin during a four-hour hemodialysis treatment. Eight
patients received 400 mg of pentoxifylline or placebo orally twice
a day over 14 days and an additional dose of 400 mg of
pentoxifylline intravenously during hemodialysis. Each subject
served as his own control in a randomized, double-blind, cross-over
study. Combined oral and intravenous treatment with pentoxifylline
prevented neither leukopenia nor neutrophil degranulation during
the time interval studied. Elastase plasma levels paralleled the
drop in leucocyte counts and thereafter increased similarly in both
groups. Lactoferrin plasma levels exhibited less increase in the
treated group; however, this effect was not statistically
significant. This may be due to the small number of cases studied
and to difficulties in reaching effective plasma levels without
side effects.