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Glomeruloesclerosis focal y segmentaria

Last reviewed: 3 Mar 2025
Last updated: 02 Apr 2024

Summary

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 investigations

1st investigations 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

Investigations 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.

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