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Última revisión: 9 Dec 2025
Última actualización: 14 Nov 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presence of risk factors
  • fatigue
  • oedema
  • nausea with/without vomiting
  • pruritus
  • skin and nail changes
  • restless legs
  • anorexia
  • infection-related glomerular disease

Otros factores de diagnóstico

  • arthralgia
  • enlarged prostate gland
  • foamy-appearing urine
  • cola- or tea-coloured urine
  • rashes
  • dyspnoea
  • orthopnoea
  • seizures
  • retinopathy

Factores de riesgo

  • diabetes mellitus
  • hypertension
  • age >50 years
  • childhood kidney disease
  • smoking
  • obesity
  • non-Hispanic black ethnicity
  • family history of CKD
  • autoimmune disorders
  • male sex
  • long-term use of non-steroidal anti-inflammatory drugs (NSAIDs)
  • high uric acid levels

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • renal chemistry
  • estimation of GFR using serum creatinine
  • estimation of GFR using cystatin C with or without serum creatinine
  • urinalysis
  • urinary albumin
  • renal ultrasound

Pruebas diagnósticas que deben considerarse

  • kidney biopsy
  • plain abdominal radiograph
  • diabetes screen
  • mineral bone disorder assessment
  • anaemia assessment

Algoritmo de tratamiento

Colaboradores

Autores

Manisha Singh, MD
Manisha Singh

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

Divulgaciones

MS is an author of a reference cited in this topic.

Michelle W. Krause, MD, MPH
Michelle W. Krause

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

Divulgaciones

MWK declares that she has no competing interests.

Agradecimientos

Dr Manisha Singh and Dr Michelle Krause would like to gratefully acknowledge Professor Sudhir V. Shah, a previous contributor to this topic.

Divulgaciones

SVS declares that he has no competing interests.

Revisores por pares

Robert Toto, MD

Professor

Internal Medicine - Nephrology

Southwestern Medical School

The University of Texas Southwestern Medical Center at Dallas

Dallas

TX

Divulgaciones

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

Divulgaciones

GHN declares that he has no competing interests.

Agradecimiento de los revisores por pares

Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.

Divulgaciones

Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024 Apr;105(4s):S117-314.Texto completo  Resumen

National Institute for Health and Care Excellence. Chronic kidney disease: assessment and management. Nov 2021 [internet publication].Texto completo

Wong-You-Cheong JJ, Nikolaidis P, Katri G, et al; Expert Panel on Urologic Imaging. ACR appropriateness criteria® renal failure. J Am Coll Radiol. 2021 May;18(5s):S174-88.Texto completo  Resumen

Kalantar-Zadeh K, Jafar TH, Nitsch D, et al. Chronic kidney disease. Lancet. 2021 Aug 28;398(10302):786-802. Resumen

Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2017 Jul;7(1):1-59.Texto completo

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible aquí.

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