Nephritis – Grade 3

Management escalation pathway

• Withhold ICPI
• Admit patient for monitoring and fluid balance
• Repeat creatinine every 24h
• Early discussion with nephrologist and need for biopsy and initiation of i.v. (methyl)prednnisolone 2 mg/kg
• Restart ICPI only when steroids are completely stopped and after multidisciplinary discussion

Assessment and Investigations

• Consider renal biopsy
• Perform UPCR