Urinary Tract Infection — Practice

Q1.Hard#Clinical

A 19-year-old man presents with recurrent episodes of cola-coloured urine occurring 2–3 days after each upper respiratory tract infection. Renal biopsy shows mesangial IgA deposits. His serum IgA levels are elevated. Urinalysis shows microscopic haematuria with mild proteinuria (0.6 g/day). Blood pressure is 125/80 mmHg and eGFR is 85 mL/min. What is the most appropriate initial management?

ACyclophosphamide and steroids

BMycophenolate mofetil monotherapy

COral prednisolone 1 mg/kg/day

DACE inhibitor (ramipril) and blood pressure optimisation

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