Kidney Week

Abstract: TH-PO0486

Kidney Protection with Targeted-Release Budesonide (Nefecon) in IgAN Across Baseline Proteinuria Levels and Variable Proteinuria Response: A Real-World Study

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - IgAN
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Limin, Chen Topwrpamnwoaro3, Department of Nephrology, Quanzhou First Hospital, Quanzhou, Fujian, China

Chen Topwrpamnwoaro3 Limin, MSc

• Shen, Shizhong, Department of Nephrology, Quanzhou First Hospital, Quanzhou, Fujian, China

Shizhong Shen

• Sun, Lingyun, Department of Nephrology, Quanzhou First Hospital, Quanzhou, Fujian, China

Lingyun Sun

• Cai, Jiaying, Department of Nephrology, Quanzhou First Hospital, Quanzhou, Fujian, China

Jiaying Cai

• Huang, Huasang, Department of Nephrology, Quanzhou First Hospital, Quanzhou, Fujian, China

Huasang Huang

Background

The 2025 KDIGO guideline highlights long-term renal preservation (annual eGFR decline <1 mL/min/1.73 m²) as a key goal. RCTs show eGFR benefit with Nefecon, but real-world data across baseline proteinuria levels and response patterns are limited.

Methods

Retrospective, single-center real-world cohort of biopsy-proven IgAN patients treated with Nefecon 16 mg/day for ≥9 months, with follow-up to 12 months (concomitant therapy per routine practice). Patients were stratified by baseline proteinuria (PCR <1000 vs ≥1000 mg/g). Response: PCR <500 mg/g or >30% reduction. Longitudinal eGFR and PCR changes were assessed overall and by strata/response.

Results

Between 2024 and 2025, 103 IgAN patients were enrolled (median age: 40 years; 51% male). Median PCR declined progressively from baseline 942.0 mg/g to 795.6 mg/g at 3 months (−15.5%), 640.9 mg/g at 6 months (−32.0%), and 513.2 mg/g at 9 months (−45.5%), with sustained reductions across both baseline PCR subgroups (<1000 vs ≥1000 mg/g). Overall treatment response rates at 3/6/9 months were 60.4%, 56.7%, and 66.7%, respectively, and were balanced between PCR strata. Median eGFR remained stable or improved throughout follow-up, rising from 65.8 to 76.3 mL/min/1.73 m² by 9 months (+16.0%), with consistent trends across subgroups. Of note, ever-responders (n=76) and non-responders (n=27) exhibited similar eGFR improvements, indicating renal protection independent of proteinuria response. The 12-month cohort (n=13) showed ongoing favorable trends in both PCR and eGFR.

Conclusion

In routine practice, Nefecon was associated with eGFR preservation through 12 months across baseline proteinuria levels and heterogeneous proteinuria responses; longer follow-up and controlled studies are needed to confirm durability and address confounding.