Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • edema
  • foamy urine
  • hypertension
  • Muehrcke lines
  • xanthelasma and xanthomata

Other diagnostic factors

  • BMI 95th percentile or greater
  • lymphadenopathy
  • skin rash
  • oral lesions
  • nephrectomy scar

Risk factors

  • male sex
  • black race
  • positive FHx
  • heroin abuse
  • use of known causative medications
  • chronic viral infection
  • solitary kidney
  • pre-existing renal disease
  • kidney transplant
  • acute renal ischemia
  • obesity

Diagnostic investigations

1st investigations to order

  • serum BUN
  • creatinine
  • GFR
  • urinalysis with microscopy
  • urine protein-to-creatinine ratio
  • 24-hour urine collection for protein
  • serum albumin
  • serum lipid profile
Full details

Investigations to consider

  • serum HIV ELISA
  • CD4 count and viral load studies
  • parvovirus DNA PCR
  • cytomegalovirus DNA PCR
  • hepatitis B and C serologies
  • ANA, anti-double-stranded DNA
  • serum and urine protein electrophoresis
  • renal biopsy
Full details

Treatment algorithm

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.

Dr Manish Suneja would like to gratefully acknowledge Dr Divya Movva, a previous contributor to this monograph. DM declares that she has no competing interests.

Peer reviewers VIEW ALL

Associate Professor

Nephrologist

McMaster University

Hamilton

Ontario

Canada

Disclosures

CC declares that she has no competing interests.

Professor of Medicine

Universite Paris-Descartes

Hopital Europeen Georges Pompidou

Paris

France

Disclosures

AM is an author of a reference cited in this monograph.

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