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IgAN Proteinuria Target 0.5 KDIGO 2025 — ESENeph MCQ

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EasyGlomerulonephritisIgAN Proteinuria Target 0.5 KDIGO 2025ESENeph

A 35-year-old man with IgA nephropathy on Nefecon for 6 months has proteinuria that has fallen from 2.0 g/day to 0.6 g/day. He asks what the ideal proteinuria target is according to the latest guideline. What does KDIGO 2025 state?

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Correct answer: CThe proteinuria target is <0.5 g/day ideally <0.3 g/day on or off treatment – this is stricter than previous guidelines

KDIGO 2025 IgAN guideline lowered the proteinuria target from the historical <1 g/day to <0.5 g/day, ideally <0.3 g/day, based on evidence that higher residual proteinuria is associated with continued nephron loss. This target applies 'on or off treatment' – meaning it should be maintained after disease-modifying therapy courses end. At 0.6 g/day, this patient is improving but has not yet reached target. Optimising supportive care (ensure maximum RASi dose, SGLT2i continued, BP <120 systolic) may achieve the final reduction, or the Nefecon course (9 months total) may provide further benefit.

Reference: KDIGO 2025 – IgA Nephropathy Guideline