Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, 100034, People's Republic of China.
Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Ministry of Education, Beijing, 100034, People's Republic of China.
J Nephrol. 2022 Mar;35(2):429-440. doi: 10.1007/s40620-021-00988-1. Epub 2021 Feb 16.
Hydroxychloroquine (HCQ) has been used as a supportive therapy for IgA nephropathy (IgAN). We aimed to determine the long-term efficacy and safety of HCQ therapy in patients with IgAN.
A total of 180 patients with IgAN who had received HCQ therapy for at least 1 year were enrolled in this study. The changes in proteinuria and the estimated glomerular filtration rate (eGFR) were analyzed during the follow-up period.
The level of proteinuria decreased from 1.69 [1.24, 2.30] to 1.01 [0.59, 1.74] g/day (- 37.58 [- 57.52, 8.24] %, P < 0.001) at 12 months and to 1.00 [0.59, 1.60] g/day (- 55.30 [- 71.09, - 3.44] %, P < 0.001) at 24 months. There was no significant change in the eGFR of these patients at 12 months (65.82 ± 25.22 vs. 63.93 ± 25.96 ml/min/1.73 m, P = 0.411); however, the eGFR decreased from 65.82 ± 25.22 to 62.15 ± 25.81 ml/min/1.73 m at 24 months (P = 0.003). The cumulative frequency of all patients with a 50% decrease in proteinuria was 72.78% at 12 months. Sixty (33.3%) patients changed to corticosteroid therapy during the follow-up period. No serious adverse effects were documented during HCQ treatment.
HCQ effectively and safely reduces proteinuria in IgAN patients with different levels of eGFR, supporting the maintenance of stable kidney function in the long term.
羟氯喹 (HCQ) 已被用作 IgA 肾病 (IgAN) 的支持性治疗。我们旨在确定 HCQ 治疗 IgAN 患者的长期疗效和安全性。
共纳入 180 例接受 HCQ 治疗至少 1 年的 IgAN 患者。在随访期间分析蛋白尿和估算肾小球滤过率 (eGFR) 的变化。
蛋白尿水平从 1.69 [1.24, 2.30] 降至 1.01 [0.59, 1.74] g/天 (-37.58 [-57.52, 8.24]%, P < 0.001)，12 个月时降至 1.00 [0.59, 1.60] g/天 (-55.30 [-71.09, -3.44]%, P < 0.001)，24 个月时。这些患者的 eGFR 在 12 个月时没有明显变化（65.82 ± 25.22 与 63.93 ± 25.96 ml/min/1.73 m，P = 0.411）；然而，eGFR 从 65.82 ± 25.22 降至 24 个月时的 62.15 ± 25.81 ml/min/1.73 m（P = 0.003）。12 个月时，所有蛋白尿减少 50%的患者累积频率为 72.78%。60 例（33.3%）患者在随访期间改为皮质类固醇治疗。在 HCQ 治疗期间未记录到严重不良反应。
HCQ 可有效、安全地降低不同 eGFR 水平的 IgAN 患者的蛋白尿，长期支持稳定的肾功能。
