Kidney Week

Abstract: TH-PO0501

Nefecon for IgAN with Lower Baseline Proteinuria: Significant Urine Protein-Creatinine Ratio (UPCR) Reduction and Preserved eGFR in Real-World Practice

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

• Yang, Li, The First Affiliated Hospital of Jinan University, Guangzhou, China

Li Yang, DrMed, PhD

• Liu, Fanna, The First Affiliated Hospital of Jinan University, Guangzhou, China

Fanna Liu, MD, PhD

• Chen, Liangmei, The First Affiliated Hospital of Jinan University, Guangzhou, China

Liangmei Chen

• Yang, Jianwei, The First Affiliated Hospital of Jinan University, Guangzhou, China

Jianwei Yang

• He, Qingsong, The First Affiliated Hospital of Jinan University, Guangzhou, China

Qingsong He, DrMed, PhD

• Chang, Yu Lin, The First Affiliated Hospital of Jinan University, Guangzhou, China

Yu Lin Chang, MD

Background

The 2025 KDIGO Clinical Practice Guideline notes that proteinuria >0.5 g/day is associated with increased risk of progression and recommends timely etiologic treatment. However, patients with 24-hour urinary protein <1 g/day were excluded from the NefIgArd trial. We evaluated the real-world efficacy and safety of Nefecon in this lower-proteinuria population.

Methods

We conducted a single-center retrospective cohort study of patients with IgA nephropathy (IgAN) and baseline 24-hour urinary protein <1 g/day. All patients received oral Nefecon 16 mg/day for ≥3 months, were on concomitant renin–angiotensin system inhibitors (RASi), and had at least one post-baseline assessment.

Results

Among 33 patients, 17 (51.5%) were female; median age was 36.0 years (95% CI, 32.0–46.0). Median UPCR at baseline and at 3, 6, and 9 months was 530.1, 328.6, 308.2, and 218.6 mg/g, corresponding to approximately 38%, 42%, and 59% reductions from baseline. Baseline eGFR was 81.6 mL/min/1.73 m². At 9 months, eGFR remained stable with an absolute change of +5.8 mL/min/1.73 m² (P=0.095). The proportion of patients with proteinuria<0.3g/g, were 45.2%, 48.4% and 66.7% in 3, 6, and 9 months, respectively. No serious adverse events were reported.

Conclusion

In this real-world cohort of IgAN patients with lower baseline proteinuria, Nefecon treatment was associated with reductions in UPCR and stable kidney function through 9 months, with no serious adverse events observed.