What does this research mean for the field?

Intensive immunosuppressive therapy with cyclophosphamide induction and azathioprine maintenance can substantially improve and preserve long-term renal function in patients with concurrent crescentic IgA nephropathy and serum-positive ANCA. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the long-term effects of immunosuppression on renal outcomes in a patient with IgAN and ANCA positivity.

June 17, 2026Open Access

Long-Term Outcome of Immunosuppression in a Patient With Immunoglobulin A Nephropathy and Serum-Positive Antineutrophil Cytoplasmic Antibodies

Key Points

To evaluate the long-term effects of immunosuppression on renal outcomes in a patient with IgAN and ANCA positivity.
Managed a patient with chronic kidney disease (CKD) using cyclophosphamide for induction and azathioprine for maintenance.
Conducted a 55-month follow-up to assess renal function after treatment.
Significant improvement in renal function was achieved with treatment.
Renal function improvements were maintained over the 55-month follow-up period.

Abstract

The concurrent occurrence of immunoglobulin A nephropathy (IgAN) and serum-positive antineutrophil cytoplasmic antibodies (ANCA) is a rare clinical entity frequently associated with more severe disease progression. Without appropriate intervention, affected individuals may rapidly advance to end-stage kidney disease (ESKD), necessitating renal replacement therapy. Early initiation of intensive induction immunosuppressive therapy has the potential to enhance renal outcomes, which can be maintained over time with suitable maintenance regimens. In this report, we describe the management of a patient with pre-existing chronic kidney disease (CKD) and impaired baseline renal function who was treated with cyclophosphamide for induction and azathioprine for maintenance for crescentic IgAN and serum-positive ANCA. This approach resulted in substantial improvement in renal function, which was preserved over a 55-month follow-up period.

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