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100+ Free ESENeph Practice Questions

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Question 1
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Muddy brown granular casts after hypotension most strongly suggest what AKI lesion?

A
B
C
D
to track
2026 Statistics

Key Facts: ESENeph Exam

9 Sep 2026

2026/01 ESENeph exam date

Federation ESENeph specialty page

200

Official exam questions

ESE regulations and ESENeph blueprint

2 x 3 hours

Paper timing

ESE regulations

GBP 700

UK exam fee

Federation ESENeph specialty page

30/200

Largest blueprint allocation

SCE in Nephrology blueprint

100

Free practice questions here

OpenExamPrep

The source row wording "SCE in Nephrology" is now normalized to ESENeph. The Federation lists ESENeph 2026/01 for 9 September 2026, with applications from 20 May to 17 June 2026, reasonable adjustment deadline 25 June 2026 and results six weeks after the exam. The exam has 200 best-of-five questions in two 3-hour computer-based papers, one mark per correct answer and no negative marking. Current fees are GBP 700 for UK candidates, EUR 800 for ESENeph full/associate/observer countries and GBP 875 for all other countries and territories.

Sample ESENeph Practice Questions

Try these sample questions to test your ESENeph exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1An adult with nephrotic syndrome has positive anti-PLA2R antibodies. What diagnosis is most likely?
A.Struvite nephrolithiasis
B.SIADH
C.Primary hyperaldosteronism
D.Primary membranous nephropathy
Explanation: Anti-PLA2R positivity strongly supports primary membranous nephropathy in an adult nephrotic presentation.
2Rapidly progressive renal failure, haematuria, pulmonary symptoms and PR3-ANCA positivity suggest what biopsy pattern?
A.Pauci-immune necrotising crescentic glomerulonephritis
B.Renal artery stenosis
C.Struvite nephrolithiasis
D.SIADH
Explanation: ANCA-associated vasculitis typically causes pauci-immune necrotising crescentic GN.
3Haemoptysis, rapidly progressive GN and anti-GBM antibodies require what urgent strategy?
A.Renal artery stenosis
B.High-dose immunosuppression with plasma exchange
C.SIADH
D.Primary hyperaldosteronism
Explanation: Anti-GBM disease with lung and kidney involvement is a renal emergency treated with immunosuppression and plasma exchange.
4Diffuse proliferative lupus nephritis is usually induced with which treatment approach?
A.Struvite nephrolithiasis
B.SIADH
C.Glucocorticoids plus mycophenolate or cyclophosphamide
D.Renal artery stenosis
Explanation: Class III/IV lupus nephritis generally requires immunosuppressive induction rather than supportive care alone.
5Recurrent visible haematuria within 24 hours of upper respiratory infections most strongly suggests what diagnosis?
A.Primary hyperaldosteronism
B.Renal artery stenosis
C.Struvite nephrolithiasis
D.IgA nephropathy
Explanation: Synpharyngitic visible haematuria is classic for IgA nephropathy.
6Nephrotic syndrome after NSAID exposure with minimal change disease on biopsy should prompt what first step?
A.Stop the offending drug and manage nephrotic complications
B.Struvite nephrolithiasis
C.SIADH
D.Primary hyperaldosteronism
Explanation: Drug-associated minimal change disease requires withdrawal of the trigger and nephrotic syndrome management.
7HIV infection with heavy proteinuria and collapsing FSGS on biopsy is best managed by what core step?
A.SIADH
B.Optimise antiretroviral therapy and proteinuric CKD care
C.Renal artery stenosis
D.Struvite nephrolithiasis
Explanation: HIV-associated nephropathy is linked to collapsing FSGS and requires HIV control plus kidney-protective care.
8AKI with fever, rash and eosinophilia after a proton pump inhibitor suggests what diagnosis?
A.Primary hyperaldosteronism
B.Renal artery stenosis
C.Drug-induced acute interstitial nephritis
D.SIADH
Explanation: PPIs, NSAIDs and antibiotics are common causes of acute interstitial nephritis.
9Myeloma with severe AKI, high free light chains and bland dipstick most suggests what lesion?
A.Renal artery stenosis
B.Struvite nephrolithiasis
C.SIADH
D.Light-chain cast nephropathy
Explanation: Light-chain cast nephropathy is a major cause of severe AKI in myeloma.
10Persistent low C3 with C3-dominant glomerular staining suggests what condition?
A.C3 glomerulopathy
B.Primary hyperaldosteronism
C.Renal artery stenosis
D.Struvite nephrolithiasis
Explanation: Dominant C3 deposition and persistent complement abnormality point to C3 glomerulopathy.

About the ESENeph Exam

From February 2020, the former Specialty Certificate Examination in Nephrology and the European Certificate in Nephrology became the European Specialty Examination in Nephrology (ESENeph). The Federation states that ESENeph is the GMC-approved mandatory summative assessment of knowledge for UK trainees in Renal Medicine as part of CCT requirements. The examination uses best-of-five questions to test renal science and clinical judgement across glomerular disease, AKI, CKD, dialysis, transplantation, hypertension, urology, inherited kidney disease and supportive renal care.

Assessment

Computer-based European Specialty Examination in Nephrology with 200 best-of-five questions across two 3-hour papers. The published blueprint covers glomerulonephritis and tubulointerstitial nephritis, AKI and fluid/electrolyte/acid-base disorders, CKD, renal bone disease and anaemia, cardiovascular disease and hypertension, urological presentations, inherited and rarer diseases, peritoneal dialysis, haemodialysis, transplantation and other renal medicine topics.

Time Limit

Two 3-hour papers taken on the same day

Passing Score

Criterion-referenced standard setting; no fixed current percentage is listed on the reviewed current specialty page.

Exam Fee

UK: GBP 700; ESENeph full/associate/observer countries: EUR 800; all other countries and territories: GBP 875 (Federation of Royal Colleges of Physicians of the UK with ERA, the European Section and Board of Nephrology and the UK Kidney Association)

ESENeph Exam Content Outline

15% (30/200)

Glomerulonephritis and tubulointerstitial nephritis

Glomerular syndromes, vasculitis, anti-GBM disease, lupus nephritis, IgA nephropathy, nephrotic syndrome and drug-related interstitial nephritis.

13% (26/200)

AKI, renal replacement, fluid, electrolytes and acid-base

AKI recognition, obstruction, rhabdomyolysis, dialysis indications, hyperkalaemia, dysnatraemia, acidosis and safe correction.

12% (24/200)

CKD, haematuria and proteinuria

CKD staging and referral, albuminuria, haematuria evaluation, renoprotective therapy, cardiovascular risk and kidney failure planning.

6% (12/200)

Renal bone disease and renal anaemia

CKD-MBD, phosphate and PTH control, calciphylaxis, iron replacement, ESA safety and anaemia targets.

10% (20/200)

Cardiovascular disease, hypertension, renovascular disease and diabetes

Resistant hypertension, primary aldosteronism, renovascular disease, diabetic kidney disease, cardiorenal syndromes and nephrotic thrombotic risk.

7% (14/200)

Urological presentations

Stone disease, obstruction, infected hydronephrosis, haematuria, urinary tract infection and reflux nephropathy.

7% (14/200)

Inherited and rarer diseases

ADPKD, Alport syndrome, Fabry disease, atypical HUS, cystinuria, tuberous sclerosis and nephronophthisis.

4% (8/200)

Peritoneal dialysis

PD peritonitis, membrane transport, ultrafiltration failure, catheter issues and encapsulating peritoneal sclerosis.

7% (14/200)

Haemodialysis

Vascular access, adequacy, intradialytic hypotension, dialysis disequilibrium, infection and modality complications.

7% (14/200)

Renal transplantation

Acute rejection, immunosuppression toxicity, BK and CMV infection, PTLD, recurrent disease and HLA sensitisation.

12% (24/200)

Other renal medicine

Prescribing in CKD, pregnancy, infection in renal patients, active supportive care, nutrition, procedures, adult-paediatric interface and end-of-life care.

How to Pass the ESENeph Exam

What You Need to Know

  • Passing score: Criterion-referenced standard setting; no fixed current percentage is listed on the reviewed current specialty page.
  • Assessment: Computer-based European Specialty Examination in Nephrology with 200 best-of-five questions across two 3-hour papers. The published blueprint covers glomerulonephritis and tubulointerstitial nephritis, AKI and fluid/electrolyte/acid-base disorders, CKD, renal bone disease and anaemia, cardiovascular disease and hypertension, urological presentations, inherited and rarer diseases, peritoneal dialysis, haemodialysis, transplantation and other renal medicine topics.
  • Time limit: Two 3-hour papers taken on the same day
  • Exam fee: UK: GBP 700; ESENeph full/associate/observer countries: EUR 800; all other countries and territories: GBP 875

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ESENeph Study Tips from Top Performers

1Map revision time to the official blueprint: glomerular disease, AKI/electrolytes and CKD together account for 80 of 200 questions.
2Practise best-of-five stems that require interpreting urinalysis, ACR, eGFR trend, serology, biopsy patterns, drug exposure and dialysis context.
3Revise emergency pathways for hyperkalaemia, pulmonary oedema, severe acidosis, infected obstruction, rapidly progressive GN and dialysis access sepsis.
4For dialysis and transplantation, link complications to immediate management: PD peritonitis, intradialytic hypotension, BK viraemia, rejection and calcineurin toxicity.
5Keep prescribing safety visible: RAAS blockade, SGLT2 inhibitors, metformin, trimethoprim, NSAIDs, phosphate binders, ESA targets and pregnancy restrictions.

Frequently Asked Questions

Is ESENeph the same as the old SCE in Nephrology?

From February 2020, the SCE in Nephrology and the European Certificate in Nephrology became a single examination called the European Specialty Examination in Nephrology (ESENeph).

When is ESENeph 2026/01?

The Federation lists ESENeph 2026/01 for 9 September 2026, with applications from 20 May to 17 June 2026 and the reasonable adjustment deadline on 25 June 2026.

What is the ESENeph format?

The ESE regulations state that each European specialty examination has two 3-hour computer-based papers, each containing 100 best-of-five questions.

What are the ESENeph fees?

The current Federation page lists GBP 700 for UK candidates, EUR 800 for candidates in ESENeph full/associate/observer countries, and GBP 875 for other countries and territories.

What blueprint areas are largest?

The largest published allocation is glomerulonephritis and tubulointerstitial nephritis at 30/200 questions, followed by AKI/fluid/electrolyte/acid-base at 26/200 and CKD/haematuria/proteinuria at 24/200.