{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:24:40Z","timestamp":1793813080457,"version":"4.6.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"STADAPHARM GmbH"},{"name":"Universit\u00e4tsklinikum Schleswig-Holstein - Campus Kiel"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Immunoglobulin A nephropathy (IgAN) is one of the most common forms of primary glomerulonephritis which can lead to kidney failure requiring kidney replacement therapy via dialysis or transplantation. Unfortunately, IgAN can recur within the allograft. For treatment of primary IgAN, a targeted-release formulation of budesonide that acts specifically within the ileum can be used to prevent disease progression. The use of targeted-release budesonide in the setting of\u00a0recurrent IgAN after transplantation has not yet been studied in detail. We here report a 28-year-old female with IgAN recurrence after transplantation, treated by targeted release budesonide\u00a0for 9 months. Prior to treatment initiation in April 2023, estimated glomerular filtration rate (eGFR) drastically decreased, reaching\u00a0 24\u00a0ml\/min\/1.73\u00a0m\n                    <jats:sup>2<\/jats:sup>\n                    within 10\u00a0months. With treatment, the eGFR decrease slowed down considerably (\u2212\u00a06\u00a0ml\/min\/1.73\u00a0m\n                    <jats:sup>2<\/jats:sup>\n                    within 12\u00a0months). The urine protein-to-creatinine-ratio (UPCR) likewise\u00a0decreased from 4.55\u00a0g\/g creatinine before therapy start to 1.30\u00a0g\/g 12\u00a0months after therapy start. Despite episodes of poorly controlled hypertension\u00a0and edema during treatment that were related to interruption of medications, blood pressure was stable at 122\/77\u00a0mmHg after 9\u00a0months and 133\/83\u00a0mmHg after 12\u00a0months. Compared to the beginning of the therapy, the patient lost 3\u00a0kg of body weight. There were no serious infections, nor was an increased susceptibility to infections observed. No other\u00a0serious adverse events occurred. Although the patient experienced corticosteroid-related side effects, treatment was not interrupted. After therapy, the side effects subsided and the patient reports general wellbeing.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical Abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s40620-025-02405-3","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T04:04:54Z","timestamp":1757649894000},"page":"2429-2434","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Treatment of recurrent IgA nephropathy after kidney transplantation with targeted-release budesonide \u2013 a case report"],"prefix":"10.1093","volume":"38","author":[{"given":"Maximilian","family":"Packbiers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Hahm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Riebeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Hinrich","family":"Br\u00e4sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4759-6441","authenticated-orcid":false,"given":"Kevin","family":"Schulte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"2405_CR1","doi-asserted-by":"publisher","first-page":"2340","DOI":"10.1093\/ndt\/gfad082","volume":"38","author":"CJ Willey","year":"2023","unstructured":"Willey CJ, Coppo R, Schaefer F et al (2023) The incidence and prevalence of IgA nephropathy in Europe. Nephrol Dial Transplant 38:2340\u20132349. https:\/\/doi.org\/10.1093\/ndt\/gfad082","journal-title":"Nephrol Dial Transplant"},{"key":"2405_CR2","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1038\/nrneph.2014.92","volume":"10","author":"ISD Roberts","year":"2014","unstructured":"Roberts ISD (2014) Pathology of IgA nephropathy. Nat Rev Nephrol 10:445\u2013454. https:\/\/doi.org\/10.1038\/nrneph.2014.92","journal-title":"Nat Rev Nephrol"},{"key":"2405_CR3","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.1016\/j.ekir.2023.09.020","volume":"8","author":"DC Cattran","year":"2023","unstructured":"Cattran DC, Floege J, Coppo R (2023) Evaluating progression risk in patients with immunoglobulin a nephropathy. Kidney Int Rep 8:2515\u20132528. https:\/\/doi.org\/10.1016\/j.ekir.2023.09.020","journal-title":"Kidney Int Rep"},{"key":"2405_CR4","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1053\/j.ajkd.2023.08.007","volume":"83","author":"DJ Caster","year":"2024","unstructured":"Caster DJ, Lafayette RA (2024) The treatment of primary IgA nephropathy: change, change, change. Am J Kidney Dis 83:229\u2013240. https:\/\/doi.org\/10.1053\/j.ajkd.2023.08.007","journal-title":"Am J Kidney Dis"},{"key":"2405_CR5","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1016\/j.kint.2020.04.046","volume":"98","author":"T Rauen","year":"2020","unstructured":"Rauen T, Wied S, Fitzner C et al (2020) After ten years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy. Kidney Int 98:1044\u20131052. https:\/\/doi.org\/10.1016\/j.kint.2020.04.046","journal-title":"Kidney Int"},{"key":"2405_CR6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.5368","author":"J Lv","year":"2022","unstructured":"Lv J, Wong MG, Hladunewich MA et al (2022) Effect of oral methylprednisolone on decline in kidney function or kidney failure in patients with IgA nephropathy. JAMA. https:\/\/doi.org\/10.1001\/jama.2022.5368","journal-title":"JAMA"},{"key":"2405_CR7","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.kint.2023.11.003","volume":"105","author":"D Wimbury","year":"2024","unstructured":"Wimbury D, Muto M, Bhachu JS et al (2024) Targeted-release budesonide modifies key pathogenic biomarkers in immunoglobulin a nephropathy: insights from the NEFIGAN trial. Kidney Int 105:381\u2013388. https:\/\/doi.org\/10.1016\/j.kint.2023.11.003","journal-title":"Kidney Int"},{"key":"2405_CR8","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/s0140-6736(23)01554-4","volume":"402","author":"R Lafayette","year":"2023","unstructured":"Lafayette R, Kristensen J, Stone A et al (2023) Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy (NefIgArd): 2-year results from a randomised phase 3 trial. Lancet 402:859\u2013870. https:\/\/doi.org\/10.1016\/s0140-6736(23)01554-4","journal-title":"Lancet"},{"key":"2405_CR9","unstructured":"European Medicines Agency (EMA). Kinpeygo(R) Summary of product characteristics. Last updated: 11\/02\/2025. https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/kinpeygo. 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In StatPearls."},{"key":"2405_CR15","doi-asserted-by":"publisher","DOI":"10.3390\/jpm14111106","author":"AN Koi","year":"2024","unstructured":"Koi AN, Johnson JC, Engebretsen TL et al (2024) Precision in immune management: balancing steroid exposure, rejection risk, and infectious outcomes in adult kidney transplant recipients. J Pers Med. https:\/\/doi.org\/10.3390\/jpm14111106","journal-title":"J Pers Med"},{"key":"2405_CR16","unstructured":"Jerling M, Rend\u00f3n-Rapp S, Kristensen J (2019). Systemic GCS Exposure from Nefecon Administration, Estimated from Suppression of Endogenous Cortisol Production. American Society of Nephrology Kidney Week. Washington, DC, USA, TH-PO1029. Available from: https:\/\/www.asn-online.org\/education\/kidneyweek\/2019\/program-abstract.aspx?controlId=3236815; Accessed 14 April 2025."},{"key":"2405_CR17","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1016\/j.kint.2023.02.012","volume":"103","author":"I Gandolfini","year":"2023","unstructured":"Gandolfini I, Alibrandi S, Gentile M et al (2023) Targeted-release budesonide in recurrent IgA nephropathy after kidney transplantation. Kidney Int 103:995\u2013996. https:\/\/doi.org\/10.1016\/j.kint.2023.02.012","journal-title":"Kidney Int"},{"key":"2405_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.02.015","author":"J Barratt","year":"2023","unstructured":"Barratt J, Rovin BH (2023) The authors reply. Kidney Int. https:\/\/doi.org\/10.1016\/j.kint.2023.02.015","journal-title":"Kidney Int"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-025-02405-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40620-025-02405-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-025-02405-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:59:27Z","timestamp":1777564767000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/38\/8\/2429\/8457499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["2405"],"URL":"https:\/\/doi.org\/10.1007\/s40620-025-02405-3","relation":{},"ISSN":["1724-6059"],"issn-type":[{"value":"1724-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]},"assertion":[{"value":"23 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"MP and KS have received honoraria from STADAPHARM as advisory board members.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"According to institutional guidelines, ethical approval from an Institutional Review Board (IRB) was not required for this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This study was conducted in accordance with the ethical standards of the Institutional and National Research Committee and with the 1964 Helsinki Declaration and its later amendments. Written informed consent for publication of this case report, including the accompanying images, was obtained from the patient. No animal studies were conducted by the authors for this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights statement"}},{"value":"Written informed consent was obtained from the patient for participation in this case report and for the publication of the associated data.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent to participate and for publication"}}]}}