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IgA Nephropathy — RACP Adult Medicine MCQ

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ModerateNephrologyIgA NephropathyRACP Adult Medicine

A 30-year-old man presents with cola-coloured urine following an upper respiratory tract infection. Urine microscopy shows dysmorphic (glomerular) red blood cells and red cell casts. Protein:creatinine ratio is 80 mg/mmol. Complement levels are normal. What is the most likely urinalysis interpretation?

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Correct answer: B — Glomerular haematuria

Dysmorphic (misshapen) red blood cells and RBC casts with proteinuria indicate glomerular haematuria. Synpharyngitic timing (concurrent with URTI, not delayed) with normal complement suggests IgA nephropathy. Red cell casts are pathognomonic of glomerular disease and localise bleeding to the kidney.

Reference: KHA – 2024 – Haematuria Guidelines; KDIGO 2025 IgAN