小结
定义
病史和体格检查
关键诊断因素
- hematuria
- edema
- hypertension
其他诊断因素
- oliguria
- anorexia
- nausea
- malaise
- weight loss
- fever
- skin rash
- arthralgia
- hemoptysis
- abdominal pain
- sore throat
- hypervolemia
危险因素
- group A beta-hemolytic Streptococcus
- respiratory infections
- gastrointestinal infections
- hepatitis B
- hepatitis C
- infective endocarditis
- HIV
- systemic lupus erythematosus (SLE)
- systemic vasculitis
- lung cancer
- colorectal cancer
- Hodgkin lymphoma
- non-Hodgkin lymphoma
- leukemia
- thymoma
- hemolytic uremic syndrome
- drugs
诊断性检查
首要检查
- urinalysis and microscopy of urine sediment
- comprehensive metabolic profile
- estimated glomerular filtration rate (eGFR)
- complete blood count
- lipid profile
- 24-hour urine collection
- ultrasound of kidneys
需考虑的检查
- 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
- antineutrophil cytoplasmic antibody
- antiglomerular basement membrane (GBM) antibody
- antistreptolysin O antibody
- antihyaluronidase
- anti-DNase
- anti-double-stranded DNA
- antinuclear antibody
- cryoglobulins
- hepatitis C virus and hepatitis B virus 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
治疗流程
mild disease
moderate-severe disease
rapidly progressive
撰稿人
作者
Nabeel Aslam, MD, FASN
Associate Professor of Medicine
Consultant Nephrologist
Mayo Clinic
Jacksonville
FL
利益声明
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.
鸣谢
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.
利益声明
JL, PP, PS, and AK declare that they have no competing interests.
同行评议者
Martin Schreiber, MD
Department Chairman
Nephrology and Hypertension
Cleveland Clinic Foundation
Cleveland
OH
利益声明
MS declares that he has no competing interests.
Patrick Naish, MB, FRCP
Teaching Fellow
Keele University Medical School
Keele
UK
利益声明
PN declares that he has no competing interests.
Richard Banks, MBBS, FRCP, MD
Consultant Nephrologist
Gloucestershire Royal Hospital
Gloucester
UK
利益声明
RB declares that he has no competing interests.
Mark Thomas, BSc, MBBS, MD, FRCP
Consultant Nephrologist
University Hospitals Birmingham
Birmingham
UK
利益声明
MT declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
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.全文 摘要
Sethi S, De Vriese AS, Fervenza FC. Acute glomerulonephritis. Lancet. 2022 Apr 23;399(10335):1646-63. 摘要
Walters GD, Willis NS, Cooper TE, et al. Interventions for renal vasculitis in adults. Cochrane Database Syst Rev. 2020 Jan 13;(1):CD003232.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Nephrolithiasis
- Bladder cancer
- Renal cancer
更多 鉴别诊断指南
- KDIGO clinical practice guideline for antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis
- KDIGO clinical practice guideline for the management of lupus nephritis
更多 指南患者教育信息
Glomerulonephritis
Kidney infection
更多 患者教育信息医学计算器
Glomerular Filtration Rate Estimate by CKD-EPI Equation
更多 医学计算器
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