Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- edema
- foamy urine
- hypertension
- Muehrcke lines
- xanthelasma and xanthomata
Outros fatores diagnósticos
- body mass index 95th percentile or greater
- lymphadenopathy
- skin rash
- oral lesions
- nephrectomy scar
Fatores de risco
- 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 ischemia
- obesity
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- serum BUN
- creatinine
- GFR
- urinalysis with microscopy
- urine protein-to-creatinine ratio
- 24-hour urine collection for protein
- serum albumin
- serum lipid profile
Investigações a serem consideradas
- 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
Algoritmo de tratamento
primary FSGS
secondary FSGS
Colaboradores
Autores
Manish Suneja, MD, FASN, FACP
Professor
Department of Internal Medicine
Division of Nephrology
University of Iowa Hospitals and Clinics
Iowa City
IA
利益声明
MS receives royalties from McGraw-Hill as an editor of the book DeGowin's Diagnostic Examination.
鸣谢
Dr Manish Suneja would like to gratefully acknowledge Dr Divya Movva, a previous contributor to this topic.
利益声明
DM declares that she has no competing interests.
同行评议者
Catherine Clase, BA, MB, MSC, FRCPC
Associate Professor
Nephrologist
McMaster University
Hamilton
Ontario
Canada
利益声明
CC declares that she has no competing interests.
Alain Meyrier, MD
Professor of Medicine
Universite Paris-Descartes
Hopital Europeen Georges Pompidou
Paris
France
利益声明
AM is an author of a reference cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Rosenberg AZ, Kopp JB. Focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2017 Mar 7;12(3):502-17.全文 摘要
Beaudreuil S, Lorenzo HK, Elias M, et al. Optimal management of primary focal segmental glomerulosclerosis in adults. Int J Nephrol Renovasc Dis. 2017 May 10;10:97-107.全文 摘要
Kidney Disease: Improving Global Outcomes. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Oct 2021 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Membranous nephropathy
- Minimal change disease
- Amyloidosis
更多 鉴别诊断指南
- KDIGO 2021 Clinical practice guideline for the management of glomerular diseases
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