Treatment of Henoch-Schönlein Purpura with Proteinuria and IgA Vasculitis Nephritis

This protocol covers Henoch-Schönlein purpura (IgA vasculitis) complicated by nephritis in patients with preserved renal function, mild or moderate proteinuria, and microscopic haematuria — a pattern representing mild renal involvement that warrants a defined first-line treatment approach.

Clinical Scenario

IgA vasculitis nephritis with a normal eGFR (>90 mL/min), mild or moderate proteinuria, and microscopic haematuria. Renal function is currently intact, but the urinary findings indicate active glomerular involvement requiring treatment.

First-Line Treatment Approach

An oral corticosteroid forms the basis of the first-line regimen for this presentation. The complete agent, dosing schedule, tapering plan, and monitoring requirements are contained in the full structured protocol.

Treatment Goals at 12 Months

Stable renal remission sustained over 12 months
eGFR >60 mL/min/1.73 m²
Urinary protein-to-creatinine ratio <30 mg/mmol
Proteinuria <1+ on dipstick
Haematuria <5 red cells per high-power field or <2+ on dipstick

Instant Access to Structured Evidence-Based Regimens

References

Mild: Normal eGFR (>90 mL/min) and mild or moderate proteinuria, microscopic haematuria
First line: oral prednisolone
Disease symptoms should be in stable remission for 12 months
An eGFR >60 mL/min/1.73 m²
UP:UC <30 mg/mmol
Proteinuria <1+ on dipstick and haematuria <5 red cells per HPF or <2+ on dipstick with a prednisolone dose <5 mg/day

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