Abstract: PUB160
Improvement in Kidney Function and Hematuria After Nefecon Treatment in Advanced IgAN: A Case Report
Session Information
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Author
- Zhou, Hongli, Department of Nephrology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
Introduction
IgA nephropathy is the most common primary glomerulonephritis worldwide. Severe Oxford-classified focal proliferative sclerosing IgAN carries high CKD progression risk. This study reports budesonide targeted-release efficacy and safety in a 36-year-old male with advanced IgAN.
Case Description
A 36-year-old Chinese male presented with 3-month proteinuria. Tests showed hematuria 2+, proteinuria 3+, Scr 118 μmol/L. Urinary protein reached 4.3 g/d, Scr 96 μmol/L; renal biopsy was initially refused. Elevated Scr to 131 μmol/L prompted biopsy on Mar 15, 2018.
Renal Pathology: Biopsy revealed focal proliferative sclerosing IgAN, Lee grade IV, Oxford M1E1S1T1C1. Findings: 3/10 global sclerosis, 3/10 segmental sclerosis, 2 cellular/fibrous crescents, 40% tubulointerstitial injury, moderate mesangial proliferation, diffuse mesangial IgA/C3 deposits.
Intervention & Follow-up: He took losartan, Kunxian capsules and dapagliflozin. Targeted-release budesonide started June 3, 2025, for 7 months.
Results: At Nefecon initiation, 24h UPro 1.84 g/day, eGFR 25.70 mL/min/1.73 m^2, SCr 236.8 μmol/L, urinary erythrocytes 22.4/μL, CysC 2.57 mg/L. After 7-month therapy, 24h UPro fell to 1.43 g/day (↓22.3%); eGFR rose to 30.22 mL/min/1.73 m^2 (+17.6%). Meanwhile, SCr dropped to 185.6 μmol/L (−21.6%), erythrocytes 6.8/μL (−69.6%), CysC 2.49 mg/L (−3.1%).
Discussion
Seven-month Nefecon reduced proteinuria and stabilized renal function safely in high-risk IgAN patients. Urinary erythrocytes and serum creatinine also declined. Prolonged budesonide targeted-release therapy may yield greater renal benefits with longer intervention.