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Glomerulonephritis

Last reviewed: 1 Nov 2024
Last updated: 17 Mar 2023

Summary

Definition

History and exam

Key diagnostic factors

  • hematuria
  • edema
  • hypertension
Full details

Other diagnostic factors

  • oliguria
  • anorexia
  • nausea
  • malaise
  • weight loss
  • fever
  • skin rash
  • arthralgia
  • hemoptysis
  • abdominal pain
  • sore throat
  • hypervolemia
Full details

Risk factors

  • 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
Full details

Diagnostic tests

1st tests to order

  • 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
Full details

Tests to consider

  • 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
Full details

Treatment algorithm

ACUTE

mild disease

moderate-severe disease

rapidly progressive

Contributors

Authors

Nabeel Aslam, MD, FASN

Associate Professor of Medicine

Consultant Nephrologist

Mayo Clinic

Jacksonville

FL

Disclosures

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.

Acknowledgements

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.

Disclosures

JL, PP, PS, and AK declare that they have no competing interests.

Peer reviewers

Martin Schreiber, MD

Department Chairman

Nephrology and Hypertension

Cleveland Clinic Foundation

Cleveland

OH

Disclosures

MS declares that he has no competing interests.

Patrick Naish, MB, FRCP

Teaching Fellow

Keele University Medical School

Keele

UK

Disclosures

PN declares that he has no competing interests.

Richard Banks, MBBS, FRCP, MD

Consultant Nephrologist

Gloucestershire Royal Hospital

Gloucester

UK

Disclosures

RB declares that he has no competing interests.

Mark Thomas, BSc, MBBS, MD, FRCP

Consultant Nephrologist

University Hospitals Birmingham

Birmingham

UK

Disclosures

MT declares that he has no competing interests.

  • Glomerulonephritis images
  • Differentials

    • Nephrolithiasis
    • Bladder cancer
    • Renal cancer
    More Differentials
  • Guidelines

    • KDIGO clinical practice guideline for glomerular diseases
    More Guidelines
  • Patient information

    Glomerulonephritis

    Kidney infection

    More Patient information
  • Calculators

    Glomerular Filtration Rate Estimate by CKD-EPI Equation

    More Calculators
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