Start before and after the kidney biopsy with supportive care which must be based on 4 essential points:

1. Bring systolic blood pressure to the target 120-130 mmHg and diastolic ≤ 80 mmHg by administering antihypertensive drugs.
ACEi or sartans are recommended in the first instance, not in combination. The administration of ACEi or sartans must reach the maximum dose tolerated by the patient from the point of view of blood pressure. Therefore, in hypertensive patients it is advisable to start, for example, with Ramipril 5 mg x 2 days (8-20 hours) and increase the dosage by 2.5 mg per dose every 3 days. In normotensive patients (≤ 120 mmHg) start with 2.5 mg x 2 per day and subsequently increase the dosage by 2.5 mg per dose every 5 days. In patients who cannot tolerate Ramipril, another ACEi or sartan can be administered. Control blood kalemia to avoid prolonged episodes of hyperkalaemia. In the presence of persistent hyperkalemia, reduce the intake of foods rich in potassium in the first instance and, subsequently, administer potassium chelators (patiromer powder or sodium zirconium cyclosilicate). These drugs should be taken 3 hours after taking other drugs. While maintaining therapy with ACEi or ARBs, calcium channel blockers can be added, preferably non-dihydropyridine (Verapamil, Diltiazem) rather than dihydropyridine calcium channel blockers (Amlodipine, Nifedipine), aldosterone antagonists and beta blockers.

2. Diet with reduced intake of animal protein (1.0 g/kg ideal body weight) in patients with CKD stage 1 and 2; change to 0.8 g/kg body weight in patients with CKD stage 3 and 0.6 g/kg/body weight in patients with eGFR ≤ 30 ml/min/1.73 m2.
Reduce salt intake to 5 g/day (a level tablespoon of salt).

3. Normalize body weight bringing it to the ideal value when in presence of overweight and obeseity adminstring with diet and exercise (30 minutes a day of brisk movement).
4. Avoid nonsteroidal anti-inflammatory drugs. In the presence of pain, take tachipirina.

The pulses of methylprednisolone emissucinate sodium (Solu Medrol) must be administered in the morning (8.00-10.00) intravenously by slow drop for the duration of 30 minutes. Methylprednisolone must be dissolved with the solvent in the package or in a 100 ml bottle of physiological solution. The amount of methylprednisolone should be calculated on the basis of the ideal body weight in the amount of 15 mg/kg body weight. Maximum 1000 mg intravenously by infusion. Definition of ideal body weight. Use Broca's formula: height - 100 for man; height - 104 for the woman. One bolus should be administered for 3 consecutive days. After the first three days, the patient should take oral prednisone in the morning (0.5 mg/kg ideal body weight, maximum 37.5 mg/day) every other day until the end of the month. This therapy should be repeated every month for 3 consecutive months after the renal biopsy. After the third month, prednisone should be reduced by 25 % each week for one month until discontinuation. The prednisone should only be administered in the morning in a single dose. Carry out glycemic control with sticks every 2 weeks. Take a gastroprotector at 7 AM in the morning.

Dapagliflozine must be adminstrated after having practiced supportive therapy with ACEi or sartans for the first four months in order to reach blood pressure values ≤ 130/80 mmHg. Dapagliflozine should be administered in the morning after breakfast in the amount of 10 mg/day a few hours after taking ACEi or sartans. The reduction in eGFR, which is observed in the first weeks after initiation of therapy, disappears after 6 weeks or with discontinuation of the drug for 2-3 weeks. No episodes of hypoglycemia are observed. Rare episodes of a cute kidney injury are observed. Make list of potential rare events adverse. Dapagliflozine must be prescribed with a treatment plan. Perform urine culture once a month in the first three months of therapy

Hyperuricemia: Allopurinol dosage related to renal function (take after lunch)
eGFR ≥ 60 ml/min/1,73 m2 300 mg/day
eGFR 30-60 ml/min/1,73 m2 150 mg/day
eGFR ≤30 ml/min/1,73 m2 100 mg/day
Type 2 diabetes mellitus: Biguanides followed by sulfonylureas and dipeptidyl peptidase 4 inhibitors.
Hypercholesterolemia:Statins 20-40 mg/day (take in the evening)
Gastroprotection of your choice. Do not take cimetidine
Do not take non-steroidal anti-inflammatory drugs
Evaluate adherence to the CLIgAN study.
Accurately record all concomitant medications at each visit in the CRF.