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IgA Nephropathy Optimisation — RACP Paediatrics MCQ

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HardNephrologyIgA Nephropathy OptimisationRACP Paediatrics

A 14-year-old boy with IgA nephropathy has persistent proteinuria of 1 g/day despite 6 months of ACE inhibitor therapy. BP is well controlled. What is the next step?

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Correct answer: B — Increase ACE inhibitor to maximum tolerated dose, add ARB (dual blockade), and optimise salt restriction before considering immunosuppression

Before starting immunosuppression in IgA nephropathy, supportive measures should be optimised: maximise ACE inhibitor/ARB dose, add the other class (dual RAS blockade with careful monitoring), restrict dietary salt, and control BP. The TESTING and STOP-IgAN trials guide immunosuppressive decisions.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: IgA Nephropathy