Berberine and Pentoxifylline: A novel combination in amelioration of acute kidney injury.

Objective: To evaluate the nephro-protective effects of berberine and/or pentoxifylline on the reduction of diclofenac-induced acute kidney injury in rats.
Methods: The experimental study was conducted at the Department of Pharmacology, College of Medicine, Mustansiriya University, Baghdad, Iraq, from February to April, 2018, and comprised fifty male Sprague-Dawley rats aged 3-4 months and weighing 250-400 grams each. They were divided into five equal groups and were treated for 12 days. Group 1 rats were treated with distilled water plus normal saline, Group 2 with distilled water plus diclofenac, Group 3 with berberine plus diclofenac, Group 4 with pentoxifylline plus diclofenac, and Group 5 rats were treated with berberine, pentoxifylline and diclofenac. Blood urea, creatinine, Neutrophil Gelatinase Associated Lipocalin (NGAL), kidney injury molecules (KIM-1) and cystatin-C were used to measure the severity of AKI.
Results: Diclofenac led to significant AKI by significant elevation of blood urea, serum creatinine level, KIM-1, NGAL. Treatment with berberine showed no significant effect on all biomarkers level compared to diclofenac group except on serum KIM-1 level which was also seen in pentoxifylline group. Whereas, combination of berberine and pentoxifylline led to more significant effect in reduction of all renal biomarkers.
Conclusions: Combination of berberine with pentoxifylline led to more significant reno-protective than either berberine or pentoxifylline when used alone on diclofenac induced-AKI.