SHORT-TERM AND LONG-TERM EFFICACY, SAFETY ASSESSMENT AND INDEPENDENT PROGNOSTIC RISK FACTORS OF HYDROXYCHLOROQUINE IN THE TREATMENT OF IGA NEPHROPATHY

Objective: To evaluate the short-term and long-term efficacy and safety of hydroxychloroquine in IgA nephropathy, and to analyse the independent risk factors for prognosis. Methods: One hundred and thirty-nine patients with IgA nephropathy were diagnosed and treated in our hospital from November 2010 to April 2012. They were randomly divided into the hydroxychloroquine group (n=70) and a control group (n=69). Both groups were treated with immunosuppressive agents and glucocorticoids. The hydroxychloroquine group was given hydroxychloroquine hydrochloride tablets orally for six months of consecutive treatment. The baseline data of age, sex ratio, blood pressure, glomerular filtration rate (eGFR), 24-hour urinary protein, serum IgA, serum albumin, serum uric acid and Lee's classification of nephropathy were collected at admission. The eGFR, 24-hour urinary protein decline and urinary protein alleviation of each patient were detected. The drug use, adverse reactions during the treatment and patient survival during the follow-up period were counted; and the independent risk factors of the prognosis were analysed. Results: There was no significant difference in baseline data between the two groups (P>0.05); there was no significant difference in cyclophosphamide usage and hormone usage between the two groups (P>0.05). The decrease of eGFR and 24-hour urinary protein in the hydroxychloroquine group was significantly higher than that in the control group (P<0.05). The total remission rate in the hydroxychloroquine group was 77.14% (54/70), that in control group was 55.07% (38169), and the total remission rate in the hydroxychloroquine group was significantly higher than that in the control group (P<0.05). The renal pathological improvement in the hydroxychloroquine group was better than that in the control group after treatment. There was no significant difference in the total adverse reaction rate between the two groups (P>0.05). The cumulative survival rate in the hydroxychloroquine group was significantly higher than that in the control group (P<0.05). Blood pressure, eGFR, 24-hour urinary protein, serum uric acid and Lee's grade of nephropathy were associated with long-term prognosis (P<0.05). Conclusion: Hydroxychloroquine can effectively improve renal function and pathological conditions in IgA nephropathy patients, improve long-term survival rates and has a high degree of safety. Blood pressure, eGFR, 24-hour urinary protein, serum uric acid and Lee's grade of nephropathy are independent risk factors for the long-term prognosis of IgA nephropathy patients.