Summary
Definition
History and exam
Key diagnostic factors
- edema
- foamy urine
- hypertension
- Muehrcke lines
- xanthelasma and xanthomata
Other diagnostic factors
- BMI 95th percentile or greater
- lymphadenopathy
- skin rash
- oral lesions
- nephrectomy scar
Risk factors
- male sex
- black race
- positive FHx
- heroin abuse
- use of known causative medications
- chronic viral infection
- solitary kidney
- pre-existing renal disease
- kidney transplant
- acute renal ischemia
- obesity
Diagnostic investigations
1st investigations to order
- serum BUN
- creatinine
- GFR
- urinalysis with microscopy
- urine protein-to-creatinine ratio
- 24-hour urine collection for protein
- serum albumin
- serum lipid profile
Investigations to consider
- serum HIV ELISA
- CD4 count and viral load studies
- parvovirus DNA PCR
- cytomegalovirus DNA PCR
- hepatitis B and C serologies
- ANA, anti-double-stranded DNA
- serum and urine protein electrophoresis
- renal biopsy
Treatment algorithm
Contributors
Authors VIEW ALL
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 monograph. DM declares that she has no competing interests.
Peer reviewers VIEW 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 monograph.
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