Side Effects of Immunosuppressive Treatments in Primary Glomerulonephritis

Abstract Background: It is imperative to closely monitor patients for adverse effects of immunosuppressive (IS) agents, widely used in treating glomerulonephritis (GN). Our study aimed to investigate the occurrence of any drug-related adverse events in patients with primary GN, explicitly focusing on IS. Methods: The present study analyzed 162 adult GN patients treated with IS drugs. The study scrutinized the demographic and clinical profiles of the patients, laboratory findings, and any side effects associated with IS drugs. We further investigated the patients for frequency and nature of infections, musculoskeletal and gastrointestinal symptoms, thromboembolism, new-onset diabetes, avascular necrosis, neuropsychiatric side effects, and premalignant conditions. Results: The study comprised a diverse group of patients with a male majority of 51.9% and a mean age of 37.2±12.9 years. The patients were under clinical observation for an average of 69.6±40.1 months, and during the treatment, 71% experienced at least one adverse effect. After evaluating the data, we did not find a significant correlation between the GN type and the presence of side effects. Research demonstrates that patients receiving corticosteroids (CS) exhibit a higher incidence of myopathy than those receiving other IS therapies (p=0.001). Hypoalbuminemia (OR: 2.05; 95% CI: 1.82–2.28; p =0.001) and steroid treatment (OR: 1.04; 95% CI: 1.01–1.06; p = 0.009) are significantly associated with increased risk of adverse outcomes. Conclusion: In cases of GN, it is not unusual for patients to encounter adversities associated with IS treatment, primarily when there is a comorbidity of hypoalbuminemia and CS exposure. The probability of these side effects occurring may increase under such circumstances. Main Points: • Patients diagnosed with GN should undergo meticulous monitoring to detect any potential adverse effects that may arise from the administration of IS agents • The probability of experiencing side effects is higher when hypoalbuminemia and CS exposure are present. • The present study suggests no discernible correlation between the type of GN and side effects.