{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T15:44:19Z","timestamp":1778341459590,"version":"3.51.4"},"reference-count":57,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background &amp; Objectives: Targeted-release budesonide (TRB) is the first approved agent aimed at targeting the early pathogenetic cascade in IgA nephropathy (IgAN). Materials and Methods: This prospective study included Caucasian IgAN patients diagnosed within the last 5 years, who had started a 10-month TRB treatment and were followed in the outpatient clinic. All participants had been on the maximal supportive care dose for at least the previous 6 months. Kidney function and proteinuria levels were recorded at the start of TRB treatment (T0) and at 3, 6, and 10 months (T3, T6, and T10, respectively), while urinary monocyte chemotactic protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9) and clusterin (CLU) levels were measured at T0 and T3. Results: In the cohort of all patients (mean age 53.24 \u00b1 12.76 years, estimated glomerular filtration rate (eGFR 52.84 \u00b1 25.93 mL\/min\/1.73 m2, proteinuria 2.84 \u00b1 1.26 g\/24 h), significant correlations were observed at T0 between MMP-9 and MCP-1 (r = 0.74, p = 0.004), MMP-9 and uCLU (r = 0.77, p = 0.002), and MCP-1 and uCLU (r = 0.65, p = 0.01). At T3, a significant correlation between MMP-9 and urinary CLU (uCLU) persisted (r = 0.71, p = 0.03). Higher MCP-1 (r = \u22120.560, p = 0.046) and MMP-9 (r = \u22120.330, p = 0.012) levels at T0 were associated with reduced proteinuria. Conversely, increased clusterin at T3 (r = 0.599, p = 0.031) was associated with worsening proteinuria. Conclusions: The treatment response to TRB was heterogeneous, with recent diagnosis (RD) patients showing improved kidney function and proteinuria, while older diagnosis (OD) patients exhibited worsening biomarkers and declining kidney function. Therefore, early interventions are crucial in IgAN patients. Finally, the biomarkers studied can be used prognostically to monitor disease progression.<\/jats:p>","DOI":"10.3390\/medicina61050807","type":"journal-article","created":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:42:37Z","timestamp":1746391357000},"page":"807","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic Value of Urinary Biomarkers in Proteinuria Progression in IgA Nephropathy Patients Treated with Budesonide"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1815-7228","authenticated-orcid":false,"given":"Christodoulos","family":"Keskinis","sequence":"first","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki (AUTH), 54642 Thessaloniki, Greece"},{"name":"Department of Nephrology, Papageorgiou Hospital, 56429 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6874-7173","authenticated-orcid":false,"given":"Eleni","family":"Moysidou","sequence":"additional","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki (AUTH), 54642 Thessaloniki, Greece"},{"name":"1st Department of Nephrology AUTH, Hippokration Hospital, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6914-9274","authenticated-orcid":false,"given":"Stamatia","family":"Stai","sequence":"additional","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki (AUTH), 54642 Thessaloniki, Greece"},{"name":"1st Department of Nephrology AUTH, Hippokration Hospital, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9565-6931","authenticated-orcid":false,"given":"Michalis","family":"Christodoulou","sequence":"additional","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki (AUTH), 54642 Thessaloniki, Greece"},{"name":"1st Department of Nephrology AUTH, Hippokration Hospital, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgios","family":"Lioulios","sequence":"additional","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki (AUTH), 54642 Thessaloniki, Greece"},{"name":"1st Department of Nephrology AUTH, Hippokration Hospital, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8043-739X","authenticated-orcid":false,"given":"Sotirios-Spyridon","family":"Vamvakas","sequence":"additional","affiliation":[{"name":"Department of Nutritional Science and Dietetics, University of Peloponnese, 24100 Kalamata, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Stella","family":"Trivyza","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, University Hospital of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2982-6426","authenticated-orcid":false,"given":"Panagiotis","family":"Pateinakis","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Papageorgiou Hospital, 56429 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-989X","authenticated-orcid":false,"given":"Marios","family":"Papasotiriou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, University Hospital of Patras, 26504 Patras, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-9863","authenticated-orcid":false,"given":"Maria","family":"Stangou","sequence":"additional","affiliation":[{"name":"School of Medicine, Aristotle University of Thessaloniki (AUTH), 54642 Thessaloniki, Greece"},{"name":"1st Department of Nephrology AUTH, Hippokration Hospital, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41581-024-00885-3","article-title":"The pathogenesis of IgA nephropathy and implications for treatment","volume":"21","author":"Cheung","year":"2024","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Keskinis, C., Moysidou, E., Christodoulou, M., Pateinakis, P., and Stangou, M. (2024). Diagnosing and Treating IgAN: Steroids, Budesonide, or Maybe Both?. Diagnostics, 14.","DOI":"10.3390\/diagnostics14050512"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1093\/ndt\/gfq665","article-title":"The incidence of primary glomerulonephritis worldwide: A systematic review of the literature","volume":"26","author":"McGrogan","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.semnephrol.2018.05.013","article-title":"Epidemiology of IgA Nephropathy: A Global Perspective","volume":"38","author":"Schena","year":"2018","journal-title":"Semin. Nephrol."},{"key":"ref_5","first-page":"709","article-title":"The commonest glomerulonephritis in the world: IgA nephropathy","volume":"64","year":"1987","journal-title":"Q. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1038\/sj.ki.5002660","article-title":"Prognostic indices and therapy in IgA nephropathy: Toward a solution","volume":"73","author":"Ballardie","year":"2008","journal-title":"Kidney Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2021.05.021","article-title":"KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases","volume":"100","author":"Rovin","year":"2021","journal-title":"Kidney Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1681\/ASN.2011050464","article-title":"The Pathophysiology of IgA Nephropathy","volume":"22","author":"Suzuki","year":"2011","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Chang, S., and Li, X.-K. (2020). The Role of Immune Modulation in Pathogenesis of IgA Nephropathy. Front. Med., 7.","DOI":"10.3389\/fmed.2020.00092"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1038\/ki.2011.501","article-title":"An update on the pathogenesis and treatment of IgA nephropathy","volume":"81","author":"Boyd","year":"2012","journal-title":"Kidney Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1038\/s41577-022-00816-y","article-title":"Glomerulonephritis: Immunopathogenesis and immunotherapy","volume":"23","author":"Anders","year":"2023","journal-title":"Nat. Rev. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1093\/ndt\/gfy323","article-title":"Modulation of the microbiota by oral antibiotics treats immunoglobulin A nephropathy in humanized mice","volume":"34","author":"Chemouny","year":"2019","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1038\/mi.2011.39","article-title":"Structure and function relationships in IgA","volume":"4","author":"Woof","year":"2011","journal-title":"Mucosal Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"(2025, March 28). IgA Nephropathy: Current Understanding and Perspectives on Pathogenesis and Targeted Treatment. Available online: https:\/\/www.mdpi.com\/2075-4418\/13\/2\/303.","DOI":"10.3390\/diagnostics13020303"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.34067\/KID.0002382022","article-title":"The Gut and Kidney Crosstalk in Immunoglobulin A Nephropathy","volume":"3","author":"Rajasekaran","year":"2022","journal-title":"Kidney360"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1053\/j.gastro.2012.05.051","article-title":"Interactions among secretory immunoglobulin A, CD71, and transglutaminase-2 affect permeability of intestinal epithelial cells to gliadin peptides","volume":"143","author":"Lebreton","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Leo, V.D., Gleeson, P.J., Sallustio, F., Bounaix, C., Silva, J.D., Loreto, G., Mkaddem, S.B., and Monteiro, R.C. (2021). Rifaximin as a Potential Treatment for IgA Nephropathy in a Humanized Mice Model. J. Pers. Med., 11.","DOI":"10.3390\/jpm11040309"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2276","DOI":"10.1681\/ASN.2022020189","article-title":"Expansion of Escherichia-Shigella in Gut Is Associated with the Onset and Response to Immunosuppressive Therapy of IgA Nephropathy","volume":"33","author":"Zhao","year":"2022","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1084\/jem.20071204","article-title":"Secretory IgA mediates retrotranscytosis of intact gliadin peptides via the transferrin receptor in celiac disease","volume":"205","author":"Moura","year":"2008","journal-title":"J. Exp. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"ii40","DOI":"10.1093\/ckj\/sfad224","article-title":"Systemic and targeted steroids for the treatment of IgA nephropathy","volume":"16","author":"Locatelli","year":"2023","journal-title":"Clin. Kidney J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"De Angelis, M., Montemurno, E., Piccolo, M., Vannini, L., Lauriero, G., Maranzano, V., Gozzi, G., Serrazanetti, D., Dalfino, G., and Gobbetti, M. (2014). Microbiota and metabolome associated with immunoglobulin A nephropathy (IgAN). PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0099006"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1016\/S0140-6736(17)30550-0","article-title":"Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): A double-blind, randomised, placebo-controlled phase 2b trial","volume":"389","author":"Barratt","year":"2017","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","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":"ref_24","doi-asserted-by":"crossref","first-page":"3237","DOI":"10.1093\/ndt\/gfr052","article-title":"New treatment for IgA nephropathy: Enteric budesonide targeted to the ileocecal region ameliorates proteinuria","volume":"26","author":"Smerud","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1161\/CIRCULATIONAHA.104.482570","article-title":"Biomarkers of cardiovascular disease: Molecular basis and practical considerations","volume":"113","author":"Vasan","year":"2006","journal-title":"Circulation"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Biomarkers Definitions Working Group (2001). Biomarkers and surrogate endpoints: Preferred definitions and conceptual framework. Clin. Pharmacol. Ther., 69, 89\u201395.","DOI":"10.1067\/mcp.2001.113989"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1001\/jama.298.17.2038","article-title":"Prevalence of chronic kidney disease in the United States","volume":"298","author":"Coresh","year":"2007","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1681\/ASN.2012010053","article-title":"Autoantibodies Targeting Galactose-Deficient IgA1 Associate with Progression of IgA Nephropathy","volume":"23","author":"Berthoux","year":"2012","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Selvaskandan, H., Shi, S., Twaij, S., Cheung, C.K., and Barratt, J. (2020). Monitoring Immune Responses in IgA Nephropathy: Biomarkers to Guide Management. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.572754"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1007\/s00467-017-3699-z","article-title":"New insights into the pathogenesis of IgA nephropathy","volume":"33","author":"Yeo","year":"2018","journal-title":"Pediatr. Nephrol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/iji.12561","article-title":"Immunological drivers of IgA Nephropathy: Exploring the mucosa-kidney link","volume":"49","author":"Selvaskandan","year":"2022","journal-title":"Int. J. Immunogenet."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1172\/JCI5535","article-title":"Circulating immune complexes in IgA nephropathy consist of IgA1 with galactose-deficient hinge region and antiglycan antibodies","volume":"104","author":"Tomana","year":"1999","journal-title":"J. Clin. Investig."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Maixnerova, D., Ling, C., Hall, S., Reily, C., Brown, R., Neprasova, M., Suchanek, M., Honsova, E., Zima, T., and Novak, J. (2019). Galactose-deficient IgA1 and the corresponding IgG autoantibodies predict IgA nephropathy progression. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0219947"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1038\/ki.2012.197","article-title":"The level of galactose-deficient IgA1 in the sera of patients with IgA nephropathy is associated with disease progression","volume":"82","author":"Zhao","year":"2012","journal-title":"Kidney Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0167-5699(90)90035-8","article-title":"Human monocyte chemoattractant protein-1 (MCP-1)","volume":"11","author":"Leonard","year":"1990","journal-title":"Immunol. Today"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1081\/JDI-120021156","article-title":"Increased urinary excretion of monocyte chemoattractant protein-1 in proteinuric renal diseases","volume":"25","author":"Morii","year":"2003","journal-title":"Ren. Fail."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1159\/000452595","article-title":"Urine Epidermal Growth Factor, Monocyte Chemoattractant Protein-1 or Their Ratio as Biomarkers for Interstitial Fibrosis and Tubular Atrophy in Primary Glomerulonephritis","volume":"41","author":"Worawichawong","year":"2016","journal-title":"Kidney Blood Press. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1159\/000107806","article-title":"Urinary excretion of monocyte chemoattractant protein-1: A biomarker of active tubulointerstitial damage in patients with glomerulopathies","volume":"30","author":"Dantas","year":"2007","journal-title":"Kidney Blood Press. Res."},{"key":"ref_39","first-page":"531","article-title":"Value of urinary levels of interleukin-6, epidermal growth factor, monocyte chemoattractant protein type1 and transforming growth factor \u03b21 in predicting the extent of fibrosis lesions in kidney biopsies of patients with IgA nephropathy","volume":"37","year":"2017","journal-title":"Nefrologia"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1038\/sj.ki.5001563","article-title":"Glomerular clusterin is associated with PKC-\u03b1\/\u03b2 regulation and good outcome of membranous glomerulonephritis in humans","volume":"70","author":"Rastaldi","year":"2006","journal-title":"Kidney Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e2215","DOI":"10.1038\/cddis.2016.113","article-title":"Clusterin facilitates apoptotic cell clearance and prevents apoptotic cell-induced autoimmune responses","volume":"7","author":"Cunin","year":"2016","journal-title":"Cell Death Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/cen.13360","article-title":"Urine clusterin\/apolipoprotein J is linked to tubular damage and renal outcomes in patients with type 2 diabetes mellitus","volume":"87","author":"Kim","year":"2017","journal-title":"Clin. Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s00441-002-0629-5","article-title":"Urinary clusterin levels in the rat correlate with the severity of tubular damage and may help to differentiate between glomerular and tubular injuries","volume":"310","author":"Hidaka","year":"2002","journal-title":"Cell Tissue Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"F1351","DOI":"10.1152\/ajprenal.00037.2012","article-title":"Matrix metalloproteinases in kidney homeostasis and diseases","volume":"302","author":"Tan","year":"2012","journal-title":"Am. J. Physiol. Ren. Physiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e6129","DOI":"10.5812\/ijp.6129","article-title":"Potential of Serum and Urinary Matrix Metalloproteinase-9 Levels for the Early Detection of Renal Involvement in Children With Henoch-Sch\u00f6nlein Purpura","volume":"26","author":"Erol","year":"2016","journal-title":"Iran. J. Pediatr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1159\/000499876","article-title":"Matrix Metalloproteinases in Renal Diseases: A Critical Appraisal","volume":"44","author":"Zakiyanov","year":"2019","journal-title":"Kidney Blood Press. Res."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Cheng, Z., Limbu, M.H., Wang, Z., Liu, J., Liu, L., Zhang, X., Chen, P., and Liu, B. (2017). MMP-2 and 9 in Chronic Kidney Disease. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18040776"},{"key":"ref_48","first-page":"1852","article-title":"Urine IL-6, IL-8, IL-33 and MMP-9 levels in patients with IgA nephropathy and their predictive value for disease progression","volume":"12","author":"He","year":"2022","journal-title":"J. Chin. Physician"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1093\/ndt\/17.7.1189","article-title":"Glomerular distribution and gelatinolytic activity of matrix metalloproteinases in human glomerulonephritis","volume":"17","author":"Urushihara","year":"2002","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Keskinis, C., Pateinakis, P., and Stangou, M. (2025). Re-biopsy may guide novel immunosuppressive therapy in long-standing IgA nephropathy. Nephrol. Dial. Transplant., gfaf039.","DOI":"10.1093\/ndt\/gfaf039"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"ii3","DOI":"10.1093\/ndt\/gfad067","article-title":"The five types of glomerulonephritis classified by pathogenesis, activity and chronicity (GN-AC)","volume":"38","author":"Romagnani","year":"2023","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1093\/ndt\/gfy341","article-title":"Repeat renal biopsy improves the oxford classification-based prediction of immunoglobulin A nephropathy outcome","volume":"35","author":"Jullien","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1053\/j.ajkd.2021.01.024","article-title":"IgA Nephropathy: Core Curriculum 2021","volume":"78","author":"Pattrapornpisut","year":"2021","journal-title":"Am. J. Kidney Dis."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Barratt, J., Lafayette, R.A., and Floege, J. (2024). Therapy of IgA nephropathy: Time for a paradigm change. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1461879"},{"key":"ref_55","unstructured":"(2025, March 31). Sparsentan in Patients with IgA Nephropathy: A Prespecified Interim Analysis from a Randomised, Double-Blind, Active-Controlled Clinical Trial\u2014The Lancet. Available online: https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(23)00569-X\/abstract."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1093\/ndt\/gfae143","article-title":"Clinical and histological comparison of IgA nephritis and renal IgA vasculitis","volume":"40","author":"Friedrich","year":"2024","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_57","unstructured":"Keskinis, C., Moysidou, E., Stai, S., Christodoulou, M., Lioulios, G., Vamvakas, S.-S., Trivyza, M.S., Pateinakis, P., Papasotiriou, M., and Stangou, M. (2025, January 4\u20137). Targeted-Release Budesonide (TRB) treatment may have different effects on the inflammatory process in IgAN patients with recent and old diagnosis. Proceedings of the 62nd ERA Congress, Vienna, Austria."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/807\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:22:03Z","timestamp":1760030523000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/807"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,26]]},"references-count":57,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["medicina61050807"],"URL":"https:\/\/doi.org\/10.3390\/medicina61050807","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,26]]}}}