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Related Experiment Videos

Antimalarial drug induced decrease in creatinine clearance

R B Landewé1, M S Vergouwen, S G Goeei The

  • 1Department of Rheumatology, University Hospital, Leiden, The Netherlands.

The Journal of Rheumatology
|January 1, 1995
PubMed
Summary
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Antimalarial drugs like chloroquine significantly reduce creatinine clearance in rheumatoid arthritis patients. Older age and chloroquine use are key factors contributing to this decline.

Area of Science:

  • Rheumatology
  • Pharmacology
  • Nephrology

Background:

  • Antimalarial drugs, including chloroquine and hydroxychloroquine, are used to treat rheumatoid arthritis.
  • Potential adverse effects on renal function, specifically creatinine clearance, require investigation.

Purpose of the Study:

  • To confirm if antimalarial drug use increases serum creatinine levels.
  • To identify factors influencing antimalarial-induced changes in creatinine clearance.

Main Methods:

  • A cohort of 118 rheumatoid arthritis patients using antimalarials (chloroquine or hydroxychloroquine) was studied.
  • Serum creatinine levels before and during antimalarial treatment were recorded.
  • Creatinine clearance was estimated using standard formulas.

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Main Results:

  • Mean creatinine clearance decreased significantly from 99 ml/min to 92 ml/min post-antimalarial initiation (p < 0.001).
  • Fifty-five percent of chloroquine users experienced >10% decrease in creatinine clearance, versus 15% of hydroxychloroquine users (p < 0.001).
  • Older age and chloroquine were independent predictors of reduced creatinine clearance.

Conclusions:

  • Antimalarial drug use leads to a significant reduction in creatinine clearance.
  • Chloroquine and advanced age are associated with a greater decrease in renal function.
  • Further research is needed to elucidate the mechanisms (glomerular filtration vs. tubular excretion) of this effect.