Effect of chlormethine hydrochloride combined with corticosteroids therapy in IgA Nephropathy: A Single-Center Retrospective Analysis

Background IgA nephropathy (IgAN) is the most prevalent primary glomerulonephritis in adults, with up to 45% of patients progressing to end-stage kidney disease (ESKD) during their disease course. The optimal therapeutic approach for IgAN remains a subject of ongoing investigation. This study reports findings from a single-center retrospective analysis of patients diagnosed with IgAN. Methods This retrospective study evaluated the treatment strategies and outcomes of biopsy-confirmed IgAN patients managed at our center between 2017 and 2022, with a specific focus on the efficacy of intravenous chlormethine hydrochloride combined with methylprednisolone (referred to as the "immunosuppressive treatment group"). A control group receiving standard supportive care was included for comparison. Results At baseline, the immunosuppressive treatment group exhibited poorer renal function and a higher body mass index. Other baseline parameters showed no significant differences between the two groups. Treatment with chlormethine hydrochloride combined with methylprednisolone led to significant renal function improvement, evidenced by a marked increase in eGFR during the observation period. Both groups demonstrated reductions in proteinuria over the follow-up period, with the immunosuppressive treatment group showing a greater reduction; however, this difference was not statistically significant. The remission rate of proteinuria was significantly higher in the immunosuppressive treatment group compared to the control group. Conclusion This study suggests that immunosuppressive therapy with chlormethine hydrochloride combined with methylprednisolone may improve renal function and proteinuria in IgAN patients. Although the role of immunosuppressive treatment in IgAN remains controversial, our findings suggest that a subset of patients may derive benefit from more intensive therapeutic strategies.