{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T10:15:57Z","timestamp":1771841757919,"version":"3.50.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009155","name":"Otsuka America Pharmaceutical, Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>With the rapidly expanding therapeutic landscape in IgA nephropathy, that incorporates new drugs with varied mechanisms of action, many of which may lead to modification of the fundamental pathophysiology of the world's commonest glomerular disease, thoughts are now turning to how we should define disease modification in IgA nephropathy. In the absence of validated biomarkers that reflect the pathogenic cascade we currently have to rely on proteinuria and eGFR, some would also advocate for inclusion of haematuria, and others for galactose-deficient IgA. In this review the approach to defining disease modification in IgA nephropathy is discussed, the approaches for how we could measure this modification and why a definition will be important as more and more new treatments become available for nephrologists.<\/jats:p>","DOI":"10.1093\/ndt\/gfaf259","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:21:30Z","timestamp":1764854490000},"page":"i53-i57","source":"Crossref","is-referenced-by-count":0,"title":["Disease modification in immunoglobulin A nephropathy"],"prefix":"10.1093","volume":"41","author":[{"given":"Jonathan","family":"Barratt","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, University of Leicester, Leicester,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"2026022304270329100_bib1","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.kint.2025.01.014","article-title":"Treatment of patients with IgA nephropathy: a call for a new paradigm","volume":"107","author":"Floege","year":"2025;","journal-title":"Kidney Int"},{"key":"2026022304270329100_bib2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2025.04.004","article-title":"KDIGO 2025 Clinical practice guideline for the management of immunoglobulin a nephropathy (IgAN) and immunoglobulin a vasculitis (IgAV)","volume":"108","author":"Kidney Disease: Improving Global Outcomes IgAN, IgAV Work Group","year":"2025","journal-title":"Kidney Int"},{"key":"2026022304270329100_bib3","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"key":"2026022304270329100_bib4","doi-asserted-by":"crossref","first-page":"469","DOI":"10.2215\/CJN.08600718","article-title":"Proteinuria reduction as a surrogate end point in trials of IgA nephropathy","volume":"14","author":"Thompson","year":"2019","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026022304270329100_bib5","doi-asserted-by":"publisher","first-page":"151572","DOI":"10.1016\/j.semnephrol.2025.151572","article-title":"Current biomarkers of IgA nephropathy","volume":"44","author":"Kamal","year":"2024","journal-title":"Semin Nephrol"},{"key":"2026022304270329100_bib6","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s00467-013-2494-8","article-title":"Remnant nephron physiology and the progression of chronic kidney disease","volume":"29","author":"Schnaper","year":"2014","journal-title":"Pediatr Nephrol"},{"key":"2026022304270329100_bib7","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1093\/ndt\/gfad215","article-title":"Tubular toxicity of proteinuria and the progression of chronic kidney disease","volume":"39","author":"Makhammajanov","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"2026022304270329100_bib8","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/S0140-6736(23)01554-4","article-title":"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","volume":"402","author":"Lafayette","year":"2023","journal-title":"Lancet"},{"key":"2026022304270329100_bib9","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1056\/NEJMoa2305635","article-title":"A Phase 2 trial of sibeprenlimab in patients with IgA nephropathy","volume":"390","author":"Mathur","year":"2024","journal-title":"N Engl J Med"},{"key":"2026022304270329100_bib10","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.kint.2025.05.006","article-title":"Zigakibart demonstrates clinical safety and efficacy in a Phase 1\/2 trial of healthy volunteers and patients with IgA nephropathy","volume":"108","author":"Kooienga","year":"2025","journal-title":"Kidney Int"},{"key":"2026022304270329100_bib11","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1681\/ASN.0000000541","article-title":"Long-term results from an open-label extension study of atacicept for the treatment of IgA nephropathy","volume":"36","author":"Barratt","year":"2025","journal-title":"J Am Soc Nephrol"},{"key":"2026022304270329100_bib12","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/j.kint.2025.05.028","article-title":"Randomized, double-blind, placebo-controlled phase 2a study assessing the efficacy and safety of felzartamab for IgA nephropathy","volume":"108","author":"Floege","year":"2025","journal-title":"Kidney Int"},{"key":"2026022304270329100_bib13","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1046\/j.1523-1755.2000.00031.x","article-title":"Renoprotective benefits of RAS inhibition: from ACEI to angiotensin II antagonists","volume":"57","author":"Taal","year":"2000","journal-title":"Kidney Int"},{"key":"2026022304270329100_bib14","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1056\/NEJMoa2024816","article-title":"Dapagliflozin in patients with chronic kidney disease","volume":"383","author":"Heerspink","year":"2020","journal-title":"N Engl J Med"},{"key":"2026022304270329100_bib15","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1056\/NEJMoa2204233","article-title":"Empagliflozin in patients with chronic kidney disease","volume":"388","author":"The EMPA-KIDNEY Collaborative Group","year":"2023","journal-title":"N Engl J Med"},{"key":"2026022304270329100_bib16","doi-asserted-by":"publisher","first-page":"2219","DOI":"10.1056\/NEJMoa2025845","article-title":"Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes","volume":"383","author":"Bakris","year":"2020","journal-title":"N Engl J Med"},{"key":"2026022304270329100_bib17","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1016\/S0140-6736(23)02302-4","article-title":"Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial","volume":"402","author":"Rovin","year":"2023","journal-title":"Lancet"},{"key":"2026022304270329100_bib18","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1056\/NEJMoa2409415","article-title":"Atrasentan in patients with IgA nephropathy","volume":"392","author":"Heerspink","year":"2025","journal-title":"N Engl J Med"},{"key":"2026022304270329100_bib19","doi-asserted-by":"publisher","first-page":"3177","DOI":"10.1681\/ASN.2007050526","article-title":"Remission of proteinuria improves prognosis in IgA nephropathy","volume":"18","author":"Reich","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"2026022304270329100_bib20","doi-asserted-by":"publisher","first-page":"727","DOI":"10.2215\/CJN.0000000000000135","article-title":"Long-term outcomes in IgA nephropathy","volume":"18","author":"Pitcher","year":"2023","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026022304270329100_bib21","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1093\/ndt\/gfae252","article-title":"Long-term outcomes of IgA nephropathy in China","volume":"40","author":"Shen","year":"2025","journal-title":"Nephrol Dial Transplant"},{"key":"2026022304270329100_bib22","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1016\/S0140-6736(19)30772-X","article-title":"Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial","volume":"393","author":"Heerspink","year":"2019","journal-title":"Lancet"},{"key":"2026022304270329100_bib23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2510198","article-title":"A phase 3 trial of atacicept in patients with IgA nephropathy","author":"Lafayette","year":"2025","journal-title":"N Engl J Med"},{"key":"2026022304270329100_bib24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2512133","article-title":"Sibeprenlimab in IgA nephropathy\u2014interim analysis of a phase 3 trial","author":"Perkovic","year":"2025","journal-title":"N Engl J Med"},{"key":"2026022304270329100_bib25","doi-asserted-by":"publisher","first-page":"572754","DOI":"10.3389\/fimmu.2020.572754","article-title":"Monitoring immune responses in IgA nephropathy: biomarkers to guide management","volume":"11","author":"Selvaskandan","year":"2020","journal-title":"Front Immunol"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfaf259\/65777941\/gfaf259.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/Supplement_1\/i53\/65777941\/gfaf259.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/Supplement_1\/i53\/65777941\/gfaf259.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T09:27:10Z","timestamp":1771838830000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/41\/Supplement_1\/i53\/8371759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":25,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2026,2,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfaf259","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2025,12,5]]}}}