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ANCA GN — ESENeph MCQ

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HardRenal VasculitisANCA GNESENeph

A 50-year-old woman with ANCA-associated vasculitis (MPO-ANCA positive) presents with rapidly progressive glomerulonephritis. Creatinine is 450 umol/L (baseline 80 umol/L). Kidney biopsy shows pauci-immune crescentic glomerulonephritis affecting 60% of glomeruli. According to KDIGO 2024 AAV guidance, what is the recommended induction regimen?

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Correct answer: D — Glucocorticoids plus Rituximab or Cyclophosphamide

KDIGO 2024 AAV guideline recommends glucocorticoids in combination with rituximab or cyclophosphamide as initial treatment for new-onset AAV (1B). In patients with markedly reduced GFR (creatinine >354 umol/L), cyclophosphamide-based induction or combined rituximab and cyclophosphamide may be preferred given limited data supporting rituximab alone in severe disease.

Reference: KDIGO 2024 – Clinical Practice Guideline for ANCA-Associated Vasculitis