Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presence of risk factors
- haematuria
- oedema
- hypertension
Outros fatores diagnósticos
- oliguria
- anorexia
- nausea
- malaise
- weight loss
- fever
- skin rash
- arthralgia
- haemoptysis
- abdominal pain
- sore throat
- hypervolaemia
Fatores de risco
- group A beta-haemolytic Streptococcus
- respiratory infections
- gastrointestinal infections
- hepatitis B
- hepatitis C
- infective endocarditis
- HIV
- systemic lupus erythematosus (SLE)
- systemic vasculitis
- lung cancer
- colorectal cancer
- Hodgkin's lymphoma
- non-Hodgkin's lymphoma
- leukaemia
- thymoma
- haemolytic uraemic syndrome
- drugs
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- urinalysis and microscopy of urine sediment
- comprehensive metabolic profile
- estimated glomerular filtration rate (eGFR)
- full blood count
- lipid profile
- 24-hour urine collection
- ultrasound of kidneys
Investigações a serem consideradas
- spot urine protein:creatinine ratio (PCR)
- spot urine albumin:creatinine ratio (ACR)
- erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
- complement levels
- rheumatoid factor
- anti-neutrophil cytoplasmic antibody
- anti-glomerular basement membrane (GBM) antibody
- antistreptolysin O antibody
- antihyaluronidase
- anti-DNase
- anti-double-stranded DNA
- antinuclear antibody
- cryoglobulins
- hepatitis C virus and hepatitis B serology
- HIV serology
- serum or urine protein electrophoresis
- serum free light chains
- drug screen
- kidney biopsy
- antiphospholipase A2 receptor antibodies
- computed tomographic scan of chest and abdomen
Algoritmo de tratamento
mild disease
moderate-severe disease
rapidly progressive
Colaboradores
Autores
Nabeel Aslam, MD, FASN
Associate Professor of Medicine
Consultant Nephrologist
Mayo Clinic
Jacksonville
FL
Declarações
NA declares that he has served on advisory boards for Travere Therapeutics and Chinook Therapeutics. He has received research grants from Idorsia, Novartis, and Baxter.
Agradecimentos
Dr Nabeel Aslam would like to gratefully acknowledge Dr Jeremy Levy, Dr Padmanabhan Premkumar, Dr Priyanka Sharma, and Dr Ajay Kumar, previous contributors to this topic.
Declarações
JL, PP, PS, and AK declare that they have no competing interests.
Revisores
Martin Schreiber, MD
Department Chairman
Nephrology and Hypertension
Cleveland Clinic Foundation
Cleveland
OH
Declarações
MS declares that he has no competing interests.
Patrick Naish, MB, FRCP
Teaching Fellow
Keele University Medical School
Keele
UK
Declarações
PN declares that he has no competing interests.
Richard Banks, MBBS, FRCP, MD
Consultant Nephrologist
Gloucestershire Royal Hospital
Gloucester
UK
Declarações
RB declares that he has no competing interests.
Mark Thomas, BSc, MBBS, MD, FRCP
Consultant Nephrologist
University Hospitals Birmingham
Birmingham
UK
Declarações
MT declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 Clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021 Oct;100(4s):S1-276.Texto completo Resumo
Sethi S, De Vriese AS, Fervenza FC. Acute glomerulonephritis. Lancet. 2022 Apr 23;399(10335):1646-63. Resumo
Walters GD, Willis NS, Cooper TE, et al. Interventions for renal vasculitis in adults. Cochrane Database Syst Rev. 2020 Jan 13;(1):CD003232.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Nephrolithiasis
- Bladder cancer
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Mais Diagnósticos diferenciaisDiretrizes
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Mais DiretrizesFolhetos informativos para os pacientes
Glomerulonephritis
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Mais Folhetos informativos para os pacientesCalculadoras
Glomerular Filtration Rate Estimate by CKD-EPI Equation
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