Mathew Gerry George, Sundaramurthy Shanmugam, Muthuperumal Prakash, Jayaprakash V
Department of Nephrology, SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, 603203, India.
Department of Computing Technologies, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, 603203, India.
BMC Nephrol. 2025 Aug 4;26(1):431. doi: 10.1186/s12882-025-04370-2.
Hydroxychloroquine is increasingly being used to treat primary glomerular diseases. It has shown promising results in terms of reducing proteinuria and stabilizing kidney function. This systematic review aimed to assess the effects of HCQ on proteinuria and the estimated glomerular filtration rate (eGFR) in primary glomerular diseases and evaluate its safety profile.
A literature search was conducted using PubMed, ScienceDirect, Springer, and Google Scholar for articles published between 2014 and 2024. Articles incorporating hydroxychloroquine for the treatment of primary glomerular diseases were considered. These studies evaluated the effect of HCQ on 24-hour proteinuria and eGFR. Pooled mean differences (MDs) and heterogeneity metrics (Tau², I², and Q-test) were analysed. The safety data from all included studies were reviewed.
HCQ administration significantly reduced proteinuria (MD = -0.69, 95% CI= -0.79 to -0.59), with pronounced effects for longer treatment durations (MD = -0.74, 95% CI= -0.81 to -0.67), and in patients with membranous nephropathy (MD = -3.00, 95% CI= -4.46 to -1.53). Conversely, no significant improvement in eGFR was observed after HCQ treatment (MD = -1.03, 95% CI= -2.73 to - 0.67). A beneficial effect was noticed in patients with IgA nephropathy (MD = -2.65, 95% CI= -5.16 to -0.14). Moderate to substantial heterogeneity (I² = 69-95%) was observed for proteinuria outcomes, but no heterogeneity was found for eGFR outcomes (I² = 0%). 69 adverse events were reported, of which gastrointestinal and mucocutaneous effects were the most common.
HCQ therapy for primary glomerular diseases showed a trend toward reducing proteinuria without significant effects on eGFR, with a better safety profile.
This systematic review was registered in PROSPERO with ID CRD42024597762.
羟氯喹越来越多地用于治疗原发性肾小球疾病。在降低蛋白尿和稳定肾功能方面已显示出有前景的结果。本系统评价旨在评估羟氯喹对原发性肾小球疾病中蛋白尿和估计肾小球滤过率（eGFR）的影响，并评估其安全性。
使用PubMed、ScienceDirect、Springer和谷歌学术搜索2014年至2024年发表的文章。纳入使用羟氯喹治疗原发性肾小球疾病的文章。这些研究评估了羟氯喹对24小时蛋白尿和eGFR的影响。分析合并平均差（MDs）和异质性指标（Tau²、I²和Q检验）。审查所有纳入研究的安全性数据。
使用羟氯喹显著降低了蛋白尿（MD = -0.69，95%CI = -0.79至-0.59），治疗时间较长时效果显著（MD = -0.74，95%CI = -0.81至-0.67），在膜性肾病患者中也是如此（MD = -3.00，95%CI = -4.46至-1.53）。相反，羟氯喹治疗后未观察到eGFR有显著改善（MD = -1.03，95%CI = -2.73至-0.67）。在IgA肾病患者中观察到有益效果（MD = -2.65，95%CI = -5.16至-0.14）。蛋白尿结果观察到中度至高度异质性（I² = 69 - 95%），但eGFR结果未发现异质性（I² = 0%）。报告了69例不良事件，其中胃肠道和皮肤黏膜影响最为常见。
羟氯喹治疗原发性肾小球疾病显示出降低蛋白尿的趋势，对eGFR无显著影响，安全性较好。
本系统评价已在PROSPERO注册，注册号为CRD42024597762。
