This protocol applies to patients aged under 18 years with a confirmed diagnosis of IgA nephropathy (IgAN). It is acknowledged that postpubertal children may in some respects follow a similar clinical course and treatment response as adults with IgAN.
The child has a diagnosis of IgA nephropathy. Management is guided by proteinuria levels and blood pressure relative to age-specific, sex-specific, and height-specific norms.
Children under 18 with IgAN and proteinuria above the relevant threshold require structured first-line intervention to prevent progressive renal injury.
The first-line approach for children with IgAN and significant proteinuria centres on RAS blockade alongside dietary sodium moderation and optimised blood pressure management. The complete protocol specifies the precise proteinuria threshold that triggers therapy, the full management algorithm, and escalation criteria.
In this guideline, we define children as those aged <18 years, but it is acknowledged that postpubertal children may in some respects have a similar course and response to treatment as adults with IgAN.
All children with IgAN and proteinuria >200 mg/d or PCR >200 mg/g (>20 mg/mmol) should receive RAS blockade, advice on moderating dietary salt intake below 3–5 g/d, and optimal lifestyle and blood pressure control (systolic blood pressure [SBP] <90th percentile for age, sex, and height).
Aim for proteinuria ≤200 mg/d (≤400 mg/1.73 m² per day) or PCR ≤200 mg/g (≤20 mg/mmol).
Aim for SBP at <90th percentile for age, sex, and height.
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