Article(id=1291704899016876419, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704811443999077, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.18.003, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1746720000000, receivedDateStr=2025-05-09, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785896046641, onlineDateStr=2026-08-05, pubDate=1758988800000, pubDateStr=2025-09-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785896046641, onlineIssueDateStr=2026-08-05, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785896046641, creator=13701087609, updateTime=1785896046641, updator=13701087609, issue=Issue{id=1291704811443999077, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='18', pageStart='2551', pageEnd='2700', issueExtLink='null', onlineDate='null', pubDate='1758988800000', pubDateStr='2025-09-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785896025763, creator='13701087609', updateTime=1785896871490, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1291708358743053253, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704811443999077, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1291708358743053254, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291704811443999077, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2588, endPage=2593, ext={EN=ArticleExt(id=1291704899251757444, articleId=1291704899016876419, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trail of finerenone combined with losartan potassium in the treatment of proteinuria in patients with chronic kidney diseaseand non-diabetic IgA nephropathy, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To investigate the clinical efficacy and safety of finerenone tablets combined with losartan potassium capsules in the treatment of patients with chronic kidney disease (stage 1-3) and non-diabetic immunoglobulin A (IgA) nephropathy.
Method Patients with chronic kidney disease (stage 1-3) and non-diabetic IgA nephropathy were divided into control group and treatment group according to different drug treatment plans. Control group was treated with losartan potassium capsules at an initial dose of 50 mg·time-1, once a day, for 3 months. Treatment group was treated with finerenone tablets at an initial dose of 20 mg·time-1, once a day, for 3 months, and combined with losartan potassium capsules, dose same as control group. The clinical efficacy and levels of renal function indexes, immunoglobulin indexes, complement indexes and inflammatory factors were compared between the two groups. The safety was evaluated.
Results A total of 96 cases were enrolled in this study. Among them, 47 cases were included in control group and 49 cases were included in treatment group. After treatment, the total effective rates in control group and treatment group were 82.98% (39 cases/47 cases) and 97.96% (48 cases/49 cases), and the treatment group was significantly higher (P<0.05). After treatment, glomerular filtration rates (eGFR) in control group and treatment group were (87.29±16.30) and (95.72±18.53) mL·min-1·1.73 m-2; 24 h urine protein levels were (0.69±0.14) and (0.48±0.10) g·24 h-1; urinary albumin-to-creatinine ratios (UACR) were (32.96±6.38) and (26.57±5.49) mg·mmol-1; blood urea nitrogen (BUN) levels were (12.68±2.24) and (11.15±2.17) mmol·L-1; serum creatinine (SCr) levels were (122.39±24.73) and (108.45±21.94) μmol·L-1; cystatin c (CysC) levels were (2.74±0.51) and (2.31±0.48) mmol·L-1; IgA levels were (2.18±0.46) and (1.73±0.39) g·L-1; complement (C) 3 levels were (0.95±0.18) and (1.14±0.22) g·L-1; C4 levels were (1.27±0.25) and (1.53±0.29) g·L-1; C1q levels were (0.19±0.05) and (0.23±0.06) g·L-1; interleukin (IL)-2 levels were (16.83±4.32) and (12.18±3.75) ng·L-1; IL-6 levels were (10.25±2.04) and (7.22±1.43) ng·L-1; high-sensitivity C-reactive protein (hs-CRP) levels were (0.52±0.16) and (0.40±0.11) mg·L-1. The differences in above indicators between treatment group and control group were statistically significant (all P<0.05). Adverse drug reactions in control group included dizziness, orthostatic hypotension, gastrointestinal reactions, skin rashes and hyperkalemia. Adverse drug reactions in treatment group included dizziness, orthostatic hypotension, gastrointestinal reactions and hyperkalemia. The total incidence rates of adverse reactions in treatment group and control group were 12.77% (6 cases/47 cases) and 14.29% (7 cases/49 cases), showing no statistically significant difference (P>0.05).
Conclusion The clinical efficacy of fenelidone tablets combined with losartan potassium capsules in treatment of chronic kidney disease (stage 1-3) with non-diabetes IgA nephropathy is more significant than that of losartan potassium capsule alone. It can significantly increase eGFR, lower urine protein level, improve renal function and immune function and alleviate micro-inflammation, with good safety.
, authors=Cai-xia YIN, Lei ZENG, Lei-zhao HUANG, Hua-you LI, authorsList=Cai-xia YIN, Lei ZENG, Lei-zhao HUANG, Hua-you LI, authorCompany=null, correspAuthors=Hua-you LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291704900782678405, articleId=1291704899016876419, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=非奈利酮联合氯沙坦钾对慢性肾病非糖尿病IgA肾病患者的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 探讨非奈利酮片联合氯沙坦钾胶囊对慢性肾病（1~3期）非糖尿病免疫球蛋白A（IgA）肾病患者的临床疗效及安全性。
方法 将慢性肾病（1~3期）非糖尿病IgA肾病患者根据不同药物治疗方案分为对照组和试验组。对照组给予氯沙坦钾胶囊，起始剂量50 mg qd，治疗3个月。试验组给予非奈利酮片联合氯沙坦钾胶囊，非奈利酮起始剂量20 mg qd，治疗3个月，氯沙坦钾胶囊剂量同对照组。比较2组患者的临床疗效、肾功能指标、免疫球蛋白指标、补体指标、炎症因子水平，并进行安全性评价。
结果 本研究共纳入96例，对照组47例，试验组49例。治疗后，对照组和试验组的总有效率分别为82.98%（39例/47例）和97.96%（48例/49例），试验组显著高于对照组（P<0.05）。治疗后，对照组和试验组的肾小球滤过率（eGFR）分别为（87.29±16.30）和（95.72±18.53）mL·min-1·1.73 m-2，24 h尿蛋白分别为（0.69±0.14）和（0.48±0.10）g·24 h-1，尿白蛋白与肌酸酐比值（UACR）分别为（32.96±6.38）和（26.57±5.49）mg·mmol-1，血尿素（BUN）分别为（12.68±2.24）和（11.15±2.17）mmol·L-1，血肌酸酐（SCr）分别为（122.39±24.73）和（108.45±21.94）μmol·L-1，胱抑素C（CysC）分别为（2.74±0.51）和（2.31±0.48）mmol·L-1，IgA分别为（2.18±0.46）和（1.73±0.39）g·L-1，补体（C）3分别为（0.95±0.18）和（1.14±0.22）g·L-1，C4分别为（1.27±0.25）和（1.53±0.29）g·L-1，C1q分别为（0.19±0.05）和（0.23±0.06）g·L-1，白细胞介素（IL）-2分别为（16.83±4.32）和（12.18±3.75）ng·L-1，IL-6分别为（10.25±2.04）和（7.22±1.43）ng·L-1，超敏C反应蛋白（hs-CRP）分别为（0.52±0.16）和（0.40±0.11）mg·L-1，试验组的上述指标与对照组比较，在统计学上差异均有统计学意义（均P<0.05）。对照组的药物不良反应有头晕、体位性低血压、消化道反应、皮疹和高钾血症，试验组的药物不良反应有头晕、体位性低血压消化道反应和高钾血症。试验组和对照组患者的总药物不良反应发生率分别为12.77%（6例/47例）和14.29%（7例/49例），在统计学上差异无统计学意义（P>0.05）。
结论 非奈利酮片联合氯沙坦钾胶囊治疗慢性肾脏病（1~3期）非糖尿病IgA肾病的临床疗效较单用氯沙坦钾胶囊更加显著，明显提高eGFR，降低尿蛋白水平，改善肾功能和免疫功能，减轻微炎症状态，且安全性良好。
, authors=殷彩霞, 曾蕾, 黄雷招, 李华友, authorsList=殷彩霞, 曾蕾, 黄雷招, 李华友, authorCompany=null, correspAuthors=李华友, authorNote=
殷彩霞（1985-），女，副主任医师，主要从事肾小球疾病及血透血管通路诊疗方面的临床工作和研究
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