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Immunosuppressant Use in Infective Endocarditis-Associated Glomerulonephritis: A Systematic Review
Reem Sayad1, Ahmed Saad Elsaeidy2, Muhammed Edib Mokresh3
1Department of Histology, Faculty of Medicine, Assiut University, Assiut, Egypt. reem.17289806@med.aun.edu.eg.
Clinical Drug Investigation
|July 19, 2025
Summary
Immunosuppressants may improve kidney function in patients with infective endocarditis-associated glomerulonephritis. While beneficial for many, outcomes vary, necessitating personalized treatment and further research for this serious kidney disease.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Infective endocarditis (IE) can lead to severe kidney disease, including IE-associated glomerulonephritis (GN).
- Standard antibiotic treatment offers a poor prognosis for renal function in these patients.
- The efficacy of immunosuppressive therapy in managing IE-associated GN requires further investigation.
Purpose of the Study:
- To systematically review the role and outcomes of immunosuppressive therapy in patients with infective endocarditis-associated glomerulonephritis.
- To evaluate the impact of immunosuppressants on both clinical and renal function in this patient population.
Main Methods:
- A systematic literature search was conducted across PubMed, Scopus, MedLine, and Web of Science up to April 2024.
- Studies involving patients with GN due to IE treated with immunosuppressants were included.
- Data extraction and quality assessment were performed using standardized tools.
Main Results:
- The review analyzed 55 studies with 84 cases; 30 patients required kidney replacement therapy.
- Immunosuppressive therapy resulted in clinical improvement in 54 cases and renal improvement in 67 cases.
- Plasma exchange and intravenous immunoglobulin were used as adjunctive therapies, with notable renal benefits in some cases.
Conclusions:
- Immunosuppressive therapy shows potential benefits for renal function in infective endocarditis-associated glomerulonephritis.
- Variability in patient response and significant mortality underscore the need for tailored treatment approaches.
- Further research is essential to optimize the management of this complex condition.
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