skip to main content

GN Comparative ESKD Risk — ESENeph MCQ

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

ModerateGlomerulonephritisGN Comparative ESKD RiskESENeph

A 35-year-old man with IgA nephropathy and CKD G3b asks about the prognosis of his condition relative to other primary glomerular diseases. Among primary glomerular diseases, which has the highest overall risk of progression to ESKD over 20 years?

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

Reveal the answer and explanation

Correct answer: E — FSGS has the highest risk of ESKD among primary GN (~50% at 10-20 years for steroid-resistant disease); IgAN has intermediate risk (~20-40% at 20 years); MN has variable risk (~30% without treatment); MCD rarely progresses to ESKD (<5%)

Among primary glomerular diseases, steroid-resistant FSGS has the worst renal prognosis (~50% ESKD at 10-20 years). IgAN has intermediate risk (~20-40% ESKD at 20 years, with wide variation based on risk factors). MN has variable prognosis (~30% ESKD without treatment; significantly better with modern therapies). MCD rarely progresses to ESKD (<5%) – the risk is from steroid toxicity and complications rather than the disease itself. These broad prognostic differences help contextualise individual counselling, though within each disease, risk varies widely based on clinical and histological features.

Reference: KDIGO 2021 – GN; Floege and Amann 2016 – GN Prognosis