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IgA nephropathy — RCPSC IM MCQ

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HardNephrologyIgA nephropathyRCPSC IM

A patient with biopsy-proven IgA nephropathy has persistent proteinuria despite optimized renin-angiotensin blockade and blood-pressure control. eGFR is 52 mL/min/1.73 m2. What is the best next step?

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Correct answer: B — Add evidence-based kidney-protective therapy and refer for disease-specific risk assessment

The best answer is “Add evidence-based kidney-protective therapy and refer for disease-specific risk assessment”. Persistent proteinuria confers progression risk despite supportive care. Current management includes additional kidney-protective therapy such as an SGLT2 inhibitor when eligible and specialist assessment for disease-specific options; immunosuppression is not automatic.

Reference: KDIGO, 2024 CKD guideline: https://kdigo.org/guidelines/ckd-evaluation-and-management/