Last reviewed: November 2017
Last updated: July  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • rash
  • oedema
  • decreased urinary volume

Other diagnostic factors

  • arthralgia
  • uveitis
  • costovertebral angle tenderness

Risk factors

  • use of a triggering medication
  • chronic inflammatory disease

Diagnostic investigations

1st investigations to order

  • serum urea and creatinine
  • FBC with WBC differential
  • urinalysis
  • urine Hansel's or Wright's eosinophil stain
  • trial of discontinuing offending medication
  • anti-neutrophil cytoplasmic antibody (ANCA)
  • anti-nuclear antibody (ANA)
  • extractable nuclear antigens (ENAs)
  • complement profile
Full details

Investigations to consider

  • renal ultrasound
  • renal biopsy
  • renal gallium scan
  • renal blood flow scan
  • renal magnetic resonance angiography
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Nephrologist and Joint Medical Director

Renal Services

Epsom & St Helier Hospitals

Carshalton

UK

Disclosures

JM declares that he has no competing interests.

Dr James Marsh would like to gratefully acknowledge Dr Alice Appel, Dr Gerald Appel and and Dr Kate Shiell, previous contributors to this monograph. AA, GA and KS declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

Disclosures

IM declares that he has no competing interests.

Associate Professor

Nephrologist

McMaster University

Hamilton

Ontario

Canada

Disclosures

CC declares that she has no competing interests.

Consultant Nephrologist/Lead Clinician

Renal Unit

Glasgow Royal Infirmary

NHS Greater Glasgow and Clyde

Glasgow

UK

Disclosures

RM declares that he has no competing interests.

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