Bilateral Cortical Necrosis Prognosis — ESENeph MCQ
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Correct answer: D — Serological diagnosis without routine kidney biopsy
The best answer is “Serological diagnosis without routine kidney biopsy”. KDIGO permits diagnosis without biopsy when nephrotic syndrome and anti-PLA2R positivity form a typical picture. Biopsy remains useful with atypical features, impaired kidney function, competing diagnoses or unexpected course. “Yes; membranous nephropathy cannot be diagnosed without biopsy in any circumstance” is less appropriate because KDIGO accepts a serological diagnosis in a typical anti-PLA2R-positive nephrotic presentation “No; serum complement alone establishes the diagnosis” is less appropriate because complement concentrations are not diagnostic of membranous nephropathy “Yes; biopsy is needed to measure serum antibody titre” is less appropriate because the antibody titre is measured in blood “No; nephrotic syndrome itself identifies the histological lesion” is less appropriate because many glomerular diseases cause nephrotic syndrome
Reference: KDIGO 2021 glomerular diseases guideline: https://kdigo.org/wp-content/uploads/2021/10/KDIGO-2021-Guideline-for-the-Management-of-Glomerular-Diseases.pdf