Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • oedema
  • elevated BP

Other diagnostic factors

  • incidental proteinuria or abnormal renal function
  • xanthelasma
  • foamy urine
  • fatigue/malaise
  • anorexia
  • Muehrcke's lines

Risk factors

  • male sex
  • age >40 years
  • HLA-DR3
  • autoimmune disease
  • hepatitis B and C
  • syphilis
  • solid organ carcinoma
  • medications
  • sarcoidosis
  • post-renal transplantation

Diagnostic investigations

1st investigations to order

  • urinalysis
  • urine protein to creatinine ratio
  • serum urea
  • serum creatinine
  • CrCl
  • serum albumin
  • lipid profile
Full details

Investigations to consider

  • serum or plasma LFTs
  • hepatitis B and C serology
  • ANA, anti-double-stranded DNA
  • complement levels
  • anti-SS-B, anti-SS-A
  • anti-PLA2R autoantibodies
  • renal ultrasound with renal artery Doppler study
  • renal biopsy
Full details

Treatment algorithm

ONGOING

Contributors

Authors VIEW ALL

Professor

Department of Internal Medicine

Division of Nephrology

University of Iowa Hospitals and Clinics

Iowa City

IA

Disclosures

MS receives royalties from McGraw-Hill as an editor of the book DeGowin's Diagnostic Examination.

Professor Manish Suneja would like to gratefully acknowledge Dr Aash Bhatt, a previous contributor to this monograph. AB declares that he has no competing interests.

Peer reviewers VIEW ALL

Medical Director

Blood Management

Cleveland Clinic

Cleveland

OH

Disclosures

AK has received a fee for speaking about perioperative blood management from Ortho-Biotech and has also received reimbursement from medscape.com for the education webcast of the same presentation.

Professor of Nephrology

Institute of Urology and Nephrology

University College London

London

UK

Disclosures

GN declares that he has no competing interests.

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