Global research trends and hotspots in targeted therapy for IgA nephropathy: a bibliometric and visualization analysis (1999-2025).

Targeted therapy has emerged as a promising precision medicine strategy for immunoglobulin A nephropathy (IgAN) through the modulation of specific pathogenic pathways. Although research in this area has accelerated, the literature remains scattered, and no bibliometric study has mapped its global knowledge structure or evolving hotspots. We conducted a bibliometric and visualization analysis of 678 publications indexed in the Web of Science Core Collection (1999-2025). CiteSpace 6.4R1, VOSviewer 1.6.20, and the R‑based bibliometric package were used to assess publication and citation trends; identify prolific countries, institutions, authors, and journals; and generate co‑authorship, co‑citation, and keyword co‑occurrence networks. Research frontiers were explored through thematic evolution mapping and keyword burst detection. Annual publications increased notably after 2015, indicating a shift from supportive care to molecularly targeted interventions. China and the United States produce over 60% of the global output, with expanding collaborations. The core themes clustered into three domains: complement inhibition (e.g., C5 blockade), B‑cell-directed therapy (including BAFF/APRIL modulation), and mucosal immune regulation. The gut-immune axis, particularly microbiome modulation, has emerged as a new frontier. Notably, recent trends highlight a growing interest in non-invasive biomarkers (e.g., urinary targets) to guide patient stratification, although clinical translation remains a challenge. This study delineates a rapidly evolving landscape of IgAN-targeted therapy. Precision approaches focusing on complement blockade, B‑cell pathways, mucosal immunity, and microbiome modulation hold substantial potential. While bibliometric data reflect a vibrant academic interest, future efforts should increasingly focus on translating candidate discoveries into clinical validation. Priority should be given to biomarker‑driven stratification and integrated diagnostic-therapeutic frameworks to accelerate translation and improve outcomes.