What is your treatment approach for pregnant patients with IgA nephropathy who have worsening proteinuria during the first trimester?  

Difficult question to answer without more details, but I would consider the following factors: One is whether it appears that the IgA is active. When was the last biopsy, and how much hematuria is present? Two would be if this is 'worsening proteinuria' is really just the first time proteinuria has ...