{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:07:20Z","timestamp":1790662040677,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["1K23AR084608"],"award-info":[{"award-number":["1K23AR084608"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002373"],"award-info":[{"award-number":["UL1TR002373"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Hydroxychloroquine (HCQ) protects kidney function in lupus nephritis (LN) by preventing flares, yet some cohort studies show no significant benefit in kidney function with HCQ. Clarifying these conflicting findings by showing early and long\u2010term benefits of HCQ on kidney function preservation is critical. Therefore, we analyzed data from our retrospective longitudinal inception LN cohort to examine the time\u2010varying effects of HCQ on kidney function decline in LN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed retrospective data from an incident biopsy\u2010proven LN cohort. Creatinine values at LN diagnosis through the last follow\u2010up were abstracted to find the estimated glomerular filtration rate (eGFR). Using HCQ exposure as a time\u2010dependent covariate, we examined associations between HCQ exposure and sustained eGFR decline \u226530% and \u226540%. We also calculated an annual eGFR slope decline by HCQ exposure using linear mixed\u2010effects analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 209 patients, 33% and 23% experienced eGFR decline \u226530% and \u226540% over time. Time\u2010varying HCQ exposure was associated with a 60% and 62% lower risk of eGFR decline of \u226530% or \u226540%, after adjusting for propensity scores. A 77% lower risk of eGFR decline was noted in patients with chronic kidney disease (CKD) stage \u22653 with HCQ. HCQ exposure reduced the annual eGFR slope decline by 5.12 and 3.17 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      within the first 5 and 10 years of diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HCQ use was associated with early and long\u2010term benefits on kidney function in LN, including those with CKD stage \u22653. Universal HCQ use should be encouraged in LN patients.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr25616-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25616","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T06:13:35Z","timestamp":1753078415000},"page":"237-248","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hydroxychloroquine Associated With Lower Glomerular Filtration Rate Decline in Lupus Nephritis"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7272-2692","authenticated-orcid":false,"given":"Shivani","family":"Garg","sequence":"first","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5639-0210","authenticated-orcid":false,"given":"Brad","family":"Rovin","sequence":"additional","affiliation":[{"name":"Ohio State University  Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad C.","family":"Astor","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tripti","family":"Singh","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fauzia","family":"Hollnagel","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Kuik","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lexie","family":"Kolton","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Callie","family":"Saric","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2361-0787","authenticated-orcid":false,"given":"S. Sam","family":"Lim","sequence":"additional","affiliation":[{"name":"Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6523-0374","authenticated-orcid":false,"given":"Christie M.","family":"Bartels","sequence":"additional","affiliation":[{"name":"University of Wisconsin  Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42375"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000016420"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2021.07.013"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2019.08.007"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42734"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21664"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.09.001"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.43212"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217728"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-021-02700-x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203319856088"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11435"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24538"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-014-2527-0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-023-04837-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead576"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307086503"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.07.013"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.07.030"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24895"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34473"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40930"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00443.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2946"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.005"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13929"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2018.02.12"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215089"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2393"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2024-001170"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1242\/dmm.048025"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker514"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep102"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-218272"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-216924"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfae001"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201940"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.5414\/CN109976"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.1035229"}],"container-title":["Arthritis Care &amp; 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