Skill Checkup: A 56-Year-Old Man With Primary IgA Nephropathy and Fatigue, Abdominal Pain, and Frothy Urine

A. Brent Alper, Jr, MD, MPH


May 01, 2023

According the KDIGO guidelines, patients with IgA nephropathy who are at high risk for rapid disease progression despite maximal supportive care for at least 3 months should receive a 6-month course of immunosuppression with glucocorticoid therapy.

Tonsillectomy is considered a therapeutic option in Japanese patients with IgA nephropathy who remain at high risk for progression despite maximal supportive therapy.

Hydroxychloroquine has been used to reduce proteinuria in Chinese patients who remain at high risk despite optimized angiotensin-converting enzyme inhibitor or angiotensin receptor blocker treatment.

Mycophenolate mofetil can be used as a potential glucocorticoid-sparing treatment agent for patients that remain steroid dependent or steroid resistant.

Editor's Note: Skill Checkups are wholly fictional or fictionalized clinical scenarios intended to provide evidence-based educational takeaways.

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