Last reviewed:September 2019
Last updated:June  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • oedema
  • foamy urine
  • hypertension
  • Muehrcke's lines
  • xanthelasma and xanthomata

Other diagnostic factors

  • body mass index 95th percentile or greater
  • lymphadenopathy
  • skin rash
  • oral lesions
  • nephrectomy scar

Risk factors

  • male sex
  • black race
  • family history of FSGS
  • heroin abuse
  • use of known causative medications
  • chronic viral infection
  • solitary kidney
  • pre-existing renal disease
  • kidney transplant
  • acute renal ischaemia
  • obesity

Diagnostic investigations

1st investigations to order

  • serum urea
  • 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 enzyme-linked immunosorbent assay
  • CD4 count and viral load studies
  • parvovirus DNA polymerase chain reaction (PCR)
  • cytomegalovirus DNA PCR
  • hepatitis B and C serologies
  • antinuclear antibody, anti-double-stranded DNA
  • serum and urine protein electrophoresis
  • renal biopsy
Full details

Treatment algorithm

Contributors

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 topic.

Peer reviewersVIEW 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 topic.

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