What are your management strategies for patients with biopsy proven IgA nephropathy with rapidly progressive glomerulonephritis?

In adults, I believe these patients should be treated similarly to other patients with RPGN. I would start out with high dose steroids, then move to possibly rituximab versus possibly cyclophosphamide shortly afterwards if no response to steroids alone.

If the patient had a prior known history of a kidney biopsy-proven diagnosis of 'primary IgA Nephropathy' and now has a concern for rapidly progressive glomerulonephritis [RPGN], my suggestions would be as follows:

1. Ask the reading pathologist of the original diagnostic kidney biopsy to provide the '...