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Glomeruloesclerosis focal y segmentaria

Última revisão: 21 Aug 2025
Última atualização: 02 Apr 2024

Resumo

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • edema
  • orina espumosa
  • hipertensión
  • líneas de Muehrcke
  • xantelasmas y xantomas
Full details

Other diagnostic factors

  • índice de masa corporal igual o superior al percentil 95
  • linfadenopatía
  • erupción cutánea
  • lesiones orales
  • cicatriz de nefrectomía
Full details

Risk factors

  • sexo masculino
  • raza negra
  • antecedentes familiares de la GEFS
  • abuso de heroína
  • uso de medicamentos causales conocidos
  • infección viral crónica
  • riñón único
  • enfermedad renal preexistente
  • trasplante de riñón
  • isquemia renal aguda
  • obesidad
Full details

Diagnostic tests

1st tests to order

  • urea sérica
  • creatinina
  • tasa de filtración glomerular (TFG)
  • análisis de orina con microscopía
  • relación proteína/creatinina en orina
  • recolección de orina de 24 horas para proteína
  • albúmina sérica
  • lipidograma sérico
Full details

Tests to consider

  • ensayo de inmunoabsorción enzimática del VIH en suero
  • recuento de CD4 y estudios de carga viral
  • ADN del parvovirus por reacción en cadena de la polimerasa (PCR)
  • ADN del citomegalovirus por reacción en cadena de la polimerasa (PCR)
  • serologías de hepatitis B y C
  • anticuerpo antinuclear, ADN bicatenario
  • electroforesis de proteínas en suero y orina
  • biopsia renal
Full details

Treatment algorithm

ACUTE

glomeruloesclerosis focal y segmentaria (GEFS) primaria

glomeruloesclerosis focal y segmentaria (GEFS) secundaria

Contributors

Authors

Manish Suneja, MD, FASN, FACP

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.

Acknowledgements

Dr Manish Suneja would like to gratefully acknowledge Dr Divya Movva, a previous contributor to this topic.

Disclosures

DM declares that she has no competing interests.

Peer reviewers

Catherine Clase, BA, MB, MSC, FRCPC

Associate Professor

Nephrologist

McMaster University

Hamilton

Ontario

Canada

Disclosures

CC declares that she has no competing interests.

Alain Meyrier, MD

Professor of Medicine

Universite Paris-Descartes

Hopital Europeen Georges Pompidou

Paris

France

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Rosenberg AZ, Kopp JB. Focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2017 Mar 7;12(3):502-17.Full text  Abstract

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.Full text  Abstract

Kidney Disease: Improving Global Outcomes. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Oct 2021 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Glomeruloesclerosis focal y segmentaria images
  • Differentials

    • Nefropatía membranosa
    • Enfermedad con cambios mínimos
    • Amiloidosis
    More Differentials
  • Guidelines

    • KDIGO 2021 Clinical practice guideline for the management of glomerular diseases
    • Evidence-based clinical practice guidelines for nephrotic syndrome
    More Guidelines
  • Patient information

    Obesidad: fármacos y cirugía

    Problemas de peso en niños

    More Patient information
  • Calculators

    Estimación de tasa de filtración glomerular por la ecuación del estudio IDMS-Traceable MDRD

    More Calculators
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