Objective To investigate the efficacy of hydroxychloroquine (HCQ) combined with angiotensin-converting enzyme inhibitor (ACEI) in the treatment of children with non-massive proteinuria IgA vasculitis nephritis (IgAVN).
Methods A total of 42 children with non-massive proteinuria IgAVN in the Guiyang Maternal and Child Healthcare Hospital from August 2023 to August 2024 were collected as the study subjects. They were divided into ACEI group (n=23) and ACEI combined with HCQ group (n=19). The urinary microalbumin level, 24-hour urinary protein, routine urinalysis, adverse reactions, electrocardiogram findings, and fundus examination results were compared between the two groups before and after treatment.
Results At 0.5, 1, 3 and 6 months of treatment, the urinary microalbumin, 24-hour urinary protein, and urinary red blood cell counts in both groups showed significantly decreasing trend (P < 0.05). At 3 and 6 months of treatment, the urinary microalbumin and 24-hour urinary protein levels in the ACEI combined with HCQ group were significantly lower than those in the ACEI group (P < 0.05). At 0.5, 1, 3, and 6 months of treatment, the urinary red blood cell counts in the ACEI combined with HCQ group were significantly lower than those in the ACEI group (P < 0.05). The total remission rate was 68.4% (13/19) in the ACEI combined with HCQ group and 56.5% (13/23) in the ACEI group, with no significant between-group difference (P>0.05). In the ACEI combined with HCQ group, there were 2 cases of nausea, 1 case of abnormal liver function, and 1 case of respiratory tract infection, with a total incidence rate of 21.1% (4/19). In the ACEI group, there were 2 cases of nausea, 2 cases of dizziness, 1 case of abnormal liver function, and 2 cases of respiratory tract infection, with a total incidence rate of 30.4% (7/23). There was significant difference in the total incidence of adverse reactions between the two groups (P=0.029). No serious adverse events such as arrhythmia or retinopathy occurred in children in the two groups.
Conclusion HCQ combined with ACEI treatment exhibits a favorable anti-urinary protein effect and good safety.
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