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IgAV Nephritis Same Management as IgAN — ESENeph MCQ

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ModerateRenal VasculitisIgAV Nephritis Same Management as IgANESENeph

A 45-year-old man develops Henoch-Schonlein purpura nephritis with crescentic IgA deposits. His eGFR is 50 and proteinuria is 2.5 g/day. According to KDIGO 2025, should management differ from primary IgA nephropathy?

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Correct answer: B — KDIGO 2025 states that management principles for IgAV nephritis are largely the same as for IgAN – supportive care (RASi, SGLT2i, BP optimisation) is foundational; crescentic disease may warrant corticosteroids; evidence base is extrapolated from IgAN

KDIGO 2025 unified the IgAN and IgAV nephritis guidelines, acknowledging their shared pathogenesis (IgA immune complex deposition). Management follows IgAN principles: supportive/foundational therapy first (RASi, SGLT2i, BP optimisation), with disease-modifying immunosuppression for those at risk of progression (significant proteinuria despite supportive care, crescentic disease). The crescentic component in this case may warrant glucocorticoids. The evidence base for IgAV nephritis in adults is largely extrapolated from IgAN data, as dedicated IgAV trials are limited.

Reference: KDIGO 2025 – IgA Nephropathy and IgA Vasculitis Guideline