Free nephrology board questions: Secondary GN

A 50-year-old woman presents with fatigue, arthralgia, and hematuria. Serum creatinine is elevated, MPO-ANCA (p-ANCA) is positive, and kidney biopsy shows pauci-immune necrotizing glomerulonephritis with crescents. Rituximab is not available at her center. Which of the following is an appropriate initial induction regimen?

A 34-year-old woman with SLE and biopsy-proven Class V lupus nephritis asks about the role of hydroxychloroquine in her regimen. According to KDIGO 2024, what is the recommended use of antimalarials in patients with lupus nephritis?

A 32-year-old woman with biopsy-proven active Class IV lupus nephritis (eGFR 70 mL/min/1.73 m2, urine protein-creatinine ratio 3.2 g/g) is to receive intravenous cyclophosphamide as part of initial therapy. When choosing between a high-dose (NIH) and a low-dose (Euro-Lupus) intravenous cyclophosphamide regimen, which statement best reflects the KDIGO 2024 recommendation?

A 58-year-old HCV-negative man with kidney failure has been on the deceased-donor waitlist for 4 years. He is offered a kidney from a donor who is HCV-viremic (NAT-positive). He has no cirrhosis and no contraindication to therapy. Which of the following is the most appropriate recommendation regarding this offer?

A 26-year-old woman with SLE had Class IV lupus nephritis treated with IV cyclophosphamide plus glucocorticoids, complicated by severe leukopenia and hemorrhagic cystitis. She achieved only a partial response on maintenance mycophenolate. She now has a biopsy-confirmed active proliferative relapse. Among the following choices, which is the most reasonable treatment option?

A 29-year-old woman with Class IV lupus nephritis achieved complete renal response after 6 months of induction with mycophenolate and glucocorticoids. She continues mycophenolate-based maintenance therapy. At 24 months from the start of immunosuppressive treatment she remains in clinical renal remission, although anti-dsDNA remains elevated and C3/C4 are low. Which of the following best reflects KDIGO 2024 guidance on duration of therapy?

A 33-year-old woman with active Class III lupus nephritis and eGFR 75 mL/min/1.73 m2 is being treated. Her nephrologist asks about voclosporin. According to KDIGO 2024, what is the role of voclosporin in lupus nephritis?