The treatment of IgA nephropathy commonly includes which agents?

• A. ACE inhibitors only
• B. Rituximab alone
• C. Steroids and mycophenolate
• D. Calcineurin inhibitors alone

Answer: (C)

Managing IgA nephropathy centers on reducing immune-mediated injury and preserving kidney function. Steroids help dampen the mesangial inflammation caused by IgA deposition, especially when proteinuria remains significant despite optimized blood pressure control. Adding mycophenolate mofetil provides additional immunosuppression by inhibiting lymphocyte proliferation, which can further reduce proteinuria and slow progression in patients where steroids alone are insufficient or where steroid-sparing is desirable. This combination targets both inflammatory activity and immune cell involvement, making it the most appropriate choice among the options. While ACE inhibitors or ARBs are essential for blood pressure control and kidney protection, and other agents like rituximab or calcineurin inhibitors have more limited or specific roles, they do not represent the well-supported immunosuppressive strategy described here.