Summary
Definition
History and exam
Key diagnostic factors
- fatigue
- edema
- nausea with/without vomiting
- pruritus
- restless legs
- anorexia
- infection-related glomerular disease
Other diagnostic factors
- arthralgia
- enlarged prostate gland
- foamy-appearing urine
- cola-colored urine
- rashes
- dyspnea
- orthopnea
- seizures
- retinopathy
Risk factors
- diabetes mellitus
- hypertension
- age >50 years
- childhood kidney disease
- smoking
- obesity
- black or Hispanic ethnicity
- family history of CKD
- autoimmune disorders
- male sex
- long-term use of nonsteroidal anti-inflammatory drugs
- high uric acid levels
Diagnostic tests
1st tests to order
- renal chemistry
- estimation of GFR
- serum cystatin C and cystatin C-based estimation of GFR
- urinalysis
- urinary albumin
- renal ultrasound
Tests to consider
- kidney biopsy
- plain abdominal radiograph
- abdominal CT
- abdominal MRI
Treatment algorithm
GFR category G1 to G2 without uremia
GFR category G3 to G4 without uremia
GFR category G5 or with uremia
Contributors
Authors
Manisha Singh, MD
![Manisha Singh](/api/image/84/en-us/normal/ManishaSingh.jpg)
Associate Professor
Division of Nephrology
Department of Internal Medicine
Director Home Dialysis Program
Co-Director M2 Renal Module
University of Arkansas for Medical Sciences
Little Rock
AR
Disclosures
MS is an author of a reference cited in this topic.
Michelle W. Krause, MD, MPH
![Michelle W. Krause](/api/image/84/en-us/normal/84-auth-1_default.jpg)
Professor of Medicine
Director, Integrated Medicine Service Line
Vice-Chair for Clinical Operations, Quality, and Efficiency
Department of Internal Medicine
University of Arkansas for Medical Sciences
Central Arkansas Veterans Healthcare System
Little Rock
AR
Disclosures
MWK declares that she has no competing interests.
Acknowledgements
Dr Manisha Singh and Dr Michelle Krause would like to gratefully acknowledge Professor Sudhir V. Shah, a previous contributor to this topic.
Disclosures
SVS declares that he has no competing interests.
Peer reviewers
Robert Toto, MD
Professor
Internal Medicine - Nephrology
Southwestern Medical School
The University of Texas Southwestern Medical Center at Dallas
Dallas
TX
Disclosures
RT declares that he has no competing interests.
Guy H. Neild, MD, FRCP, FRCPath
Professor of Nephrology
UCL Division of Medicine
University College London
London
UK
Disclosures
GHN declares that he has no competing interests.
Differentials
- Diabetic kidney disease
- Hypertensive nephrosclerosis
- Ischemic nephropathy
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