{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:47:57Z","timestamp":1791823677986,"version":"4.3.4"},"reference-count":34,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kidney Blood Press Res"],"abstract":"<jats:p>Introduction: IgA nephropathy (IgAN) with nephrotic-range proteinuria (NRP) comprises two distinct presentations \u2013 with and without hypoalbuminemia, and comparative outcome data are limited, particularly for patients with preserved serum albumin. Methods: From a multicenter cohort of patients with IgAN and NRP, 127 patients were divided into a nephrotic syndrome (NS) group (NRP with hypoalbuminemia) and an NRP with normal serum albumin (NRP-NA) group. We compared baseline features, 1-year outcomes, and progression to a composite endpoint of a \u226530% decline in estimated glomerular filtration rate (eGFR) or progression to end-stage kidney disease and evaluated predictors of the composite endpoint. Immunosuppressive exposure was ascertained, and proteinuria response was classified as complete or partial remission. Results: The NS group showed higher levels of C-reactive protein, lipids, and proteinuria and exhibited more pronounced diffuse foot process effacement than the NRP-NA group. After 1 year, the NS group demonstrated greater eGFR recovery and proteinuria reduction than the NRP-NA group. Overall remission rates were similar (75.61% vs. 81.71%), but complete remission was three times more frequent in the NS group (29.27% vs. 9.76%, p = 0.009) whereas the NRP-NA group more often remained in partial remission (46.34% vs. 71.95%, p = 0.009). Composite endpoint-free survival was lower in the NS group (p = 0.010), but this difference did not persist after adjustment for baseline eGFR (hazard ratio [HR], 1.586; 95% confidence interval [CI], 0.883\u20132.849; p = 0.123). In multivariable analysis, baseline eGFR was the dominant predictor of the composite outcome (HR per mL\/min\/1.73 m2, 0.978; 95% CI, 0.967\u20130.989; p &lt; 0.001), whereas renin-angiotensin system inhibition was independently associated with a lower risk of kidney events (HR, 0.357; 95% CI, 0.146\u20130.874; p = 0.024). Conclusion: IgAN patients with NS and those with NRP-NA showed distinct patterns of proteinuria response, and the apparent difference in long-term kidney outcome did not persist after adjustment for baseline kidney function. Renin-angiotensin system inhibition was independently associated with a lower risk of kidney disease progression.<\/jats:p>","DOI":"10.1159\/kbr\/adjag009","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:15:04Z","timestamp":1788520504000},"page":"936-952","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Clinical and Pathological Traits in IgA Nephropathy Patients with Nephrotic Syndrome or Nephrotic Range Proteinuria"],"prefix":"10.1159","volume":"51","author":[{"given":"Sang Hun","family":"Eum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1282-7876","authenticated-orcid":false,"given":"Eun Sil","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0048-5717","authenticated-orcid":false,"given":"Byung 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