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Case Reports
. 2025 Jul 25;17(7):e88734.
doi: 10.7759/cureus.88734. eCollection 2025 Jul.

Rapidly Progressive Kidney Disease in a Patient With IgA Nephropathy and Focal Segmental Glomerulosclerosis Due to Nonadherence and Loss to Follow-Up

Zaheeruddin Sayed  1 , Victoria Bellot  1 , Javier J Mendoza Mulen  1
Affiliations
Case Reports

Rapidly Progressive Kidney Disease in a Patient With IgA Nephropathy and Focal Segmental Glomerulosclerosis Due to Nonadherence and Loss to Follow-Up

Zaheeruddin Sayed et al. Cureus. .

Abstract

We report a case of a 63-year-old Hispanic female with hypertension and prediabetes, diagnosed with IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) in 2023. Despite detailed counseling about immunosuppressive therapy, the patient initially refused treatment due to fear of medication side effects. Over two years without consistent nephrology follow-up, her condition rapidly progressed to nephrotic syndrome and end-stage renal disease (ESRD). Later, immunosuppressive therapy, including corticosteroids, mycophenolate mofetil (MMF), and targeted-release budesonide (Tarpeyo), was initiated, but her kidney function continued to worsen. This case underscores the importance of ongoing nephrology follow-up and patient re-engagement in managing progressive glomerular diseases, especially in patients who initially decline therapy.

Keywords: end-stage renal disease; focal segmental glomerulosclerosis; iga nephropathty; immunosuppressive therapy; lost to follow-up; nonadherence; targeted-release budesonide.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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