skip to main content

Crescentic IgA Nephropathy — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardGlomerulonephritisCrescentic IgA NephropathyESENeph

A 45-year-old man with known IgA nephropathy and eGFR of 48 mL/min/1.73m2 has a rapid decline in eGFR to 22 mL/min/1.73m2 over 8 weeks. He has increasing proteinuria and active urinary sediment. Repeat biopsy shows crescentic IgA nephropathy with 55% crescents. What is the recommended treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Cyclophosphamide plus systemic Glucocorticoids (as per ANCA vasculitis protocol)

KDIGO 2025 IgAN guideline defines rapidly progressive IgAN as ≥50% decline in eGFR over ≤3 months. Patients with extensive crescent formation should be offered treatment with cyclophosphamide and systemic glucocorticoids in accordance with the KDIGO 2024 ANCA vasculitis guideline. Nefecon is not appropriate for rapidly progressive disease. There is insufficient evidence for Rituximab in rapidly progressive IgAN.

Reference: KDIGO 2025 – IgA Nephropathy Guideline