A kidney biopsy in IgA nephropathy shows crescents in 30% of glomeruli, but eGFR has been stable for six months and proteinuria is falling with

Question

A kidney biopsy in IgA nephropathy shows crescents in 30% of glomeruli, but eGFR has been stable for six months and proteinuria is falling with optimised supportive therapy. Which interpretation is most appropriate?

Accepted Answer

Crescents alone do not define RPGN; follow the eGFR trajectory

Answer

Use cyclophosphamide because 25% crescent formation defines rapidly progressive disease

Answer

Stop renin–angiotensin blockade and use glucocorticoid monotherapy

Answer

Treat with mycophenolate because stable eGFR confirms a non-progressive immune phenotype

Answer

Use plasma exchange because the biopsy resembles anti-GBM glomerulonephritis

Adult IgA Vasculitis Prognosis — SCE Rheumatology MCQ

A kidney biopsy in IgA nephropathy shows crescents in 30% of glomeruli, but eGFR has been stable for six months and proteinuria is falling with optimised supportive therapy. Which interpretation is most appropriate?