Kidney Week

Abstract: FR-PO1163

Effects of Budesonide (Tarpeyo) in Recurrent IgA Nephropathy After Transplant

Session Information

• Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Saeed, Wajeeha, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States

Wajeeha Saeed, MD, MPH

• Lopez-Gutierrez, Pedro A., The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States

Pedro A. Lopez-Gutierrez, MD

• Duggan, Jonathan, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States

Jonathan Duggan, RN

• Dauenhauer, Ashlee, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States

Ashlee Dauenhauer, PharmD

• Singh, Namita, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States

Namita Singh, MD, MBBS, FASN

• Garcia, Pablo, The University of New Mexico Department of Internal Medicine, Albuquerque, New Mexico, United States

Pablo Garcia, MD, MS, FASN

Introduction

IgA nephropathy (IgAN) recurs in 16% of kidney transplant recipients and is a significant cause of allograft loss. Management of recurrence is challenging given the absence of clinical trials evaluating novel IgAN-directed therapies in the transplant population. We present a case of recurrent IgAN after kidney transplantation treated with budesonide delayed release (DR).

Case Description

A 47-year-old female with history of biopsy-proven IgAN underwent a LRKT. She received induction with thymoglobulin and was maintained on tacrolimus, mycophenolic acid and prednisone. One year post transplant, due to persistent proteinuria, she underwent renal biopsy showing recurrent IgAN. Losartan was initiated, however, after six months without significant improvement, budesonide DR was added and continued for nine months. During treatment, kidney function remained stable and proteinuria decreased (Figure 1). Notable adverse effects included body aches, menorrhagia, and a weight gain of approximately 15 pounds.

Discussion

This case illustrates the potential benefit of budesonide DR in managing recurrent IgAN after kidney transplantation, a setting for which evidence-based guidance is lacking. Our patient demonstrated preserved allograft function and reduced proteinuria over nine months of therapy. As novel IgAN-directed therapies continue to gain approval in the native kidney setting, clinical trials are needed to evaluate their safety and efficacy in transplant recipients with recurrent disease.

Figure 1. Shows trend in UPCR and eGFR over months.