Summary
Definition
History and exam
Other diagnostic factors
- oliguria
- anorexia
- nausea
- malaise
- weight loss
- fever
- skin rash
- arthralgia
- hemoptysis
- abdominal pain
- sore throat
- hypervolemia
Risk factors
- group A beta-hemolytic Streptococcus
- respiratory infections
- gastrointestinal infections
- hepatitis B
- hepatitis C
- infective endocarditis
- HIV
- systemic lupus erythematosus (SLE)
- systemic vasculitis
- Hodgkin lymphoma
- lung cancer
- colorectal cancer
- non-Hodgkin lymphoma
- leukemia
- thymoma
- hemolytic uremic syndrome
- drugs
Diagnostic investigations
1st investigations to order
- urinalysis and urine microscopy
- comprehensive metabolic profile
- glomerular filtration rate (GFR)
- complete blood count
- lipid profile
- spot urine albumin:creatinine ratio (ACR)
- ultrasound of kidneys
Investigations to consider
- 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
- electrophoresis
- drug screen
- renal biopsy
- antiphospholipase A2 receptor antibodies
- computed tomographic scan of chest and abdomen
Treatment algorithm
Contributors
Authors
Professor of Practice (Medicine)
Director of Clinical Academic Training
Imperial College London
Consultant Nephrologist
Imperial College Healthcare NHS Trust
London
UK
Disclosures
JL declares that he has no competing interests.
Dr Jeremy Levy would like to gratefully acknowledge Dr Padmanabhan Premkumar, Dr Priyanka Sharma, and Dr Ajay Kumar, previous contributors to this topic. PP, PS, and AK declare that they have no competing interests.
Peer reviewers
Department Chairman
Nephrology and Hypertension
Cleveland Clinic Foundation
Cleveland
OH
Disclosures
MS declares that he has no competing interests.
Teaching Fellow
Keele University Medical School
Keele
UK
Disclosures
PN declares that he has no competing interests.
Consultant Nephrologist
Gloucestershire Royal Hospital
Gloucester
UK
Disclosures
RB declares that he has no competing interests.
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