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Glomerulonefrite

Last reviewed: 4 May 2025
Last updated: 14 Feb 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • hematúria
  • edema
  • hipertensão
Full details

Other diagnostic factors

  • oligúria
  • anorexia
  • náuseas
  • mal-estar
  • perda de peso
  • febre
  • erupção cutânea
  • artralgia
  • hemoptise
  • dor abdominal
  • faringite
  • hipervolemia
Full details

Risk factors

  • Streptococcus beta-hemolítico do grupo A
  • infecções respiratórias
  • infecções gastrointestinais
  • hepatite B
  • hepatite C
  • endocardite infecciosa
  • vírus da imunodeficiência humana (HIV)
  • lúpus eritematoso sistêmico (LES)
  • vasculite sistêmica
  • câncer pulmonar
  • câncer colorretal
  • Linfoma de Hodgkin
  • linfoma não Hodgkin
  • leucemia
  • timoma
  • síndrome hemolítico-urêmica
  • medicamentos
Full details

Diagnostic investigations

1st investigations to order

  • urinálise e microscopia do sedimento urinário
  • perfil metabólico abrangente
  • taxa de filtração glomerular estimada (TFGe)
  • hemograma completo
  • perfil lipídico
  • urina de 24 horas
  • ultrassonografia dos rins
Full details

Investigations to consider

  • relação proteína/creatinina (RPC) na amostra de urina
  • proporção creatinina/albumina em amostra de urina (RCA)
  • velocidade de hemossedimentação (VHS) e/ou proteína C-reativa
  • níveis do complemento
  • fator reumatoide
  • anticorpo anticitoplasma de neutrófilo
  • anticorpo antimembrana basal glomerular (GBM)
  • anticorpo antiestreptolisina O
  • anti-hialuronidase
  • anti-DNase
  • anti-DNA de fita dupla
  • fator antinuclear (FAN)
  • crioglobulinas
  • sorologia para vírus da hepatite C e da hepatite B
  • sorologia do HIV
  • eletroforese de proteínas séricas ou urinárias
  • cadeias leves livres no soro
  • triagem para uso de drogas ilícitas
  • biópsia renal
  • anticorpos contra o receptor da fosfolipase A2
  • tomografia computadorizada do tórax e abdome
Full details

Treatment algorithm

ACUTE

doença leve

doença moderada a grave

rapidamente progressiva

Contributors

Authors

Nabeel Aslam, MD, FASN

Associate Professor of Medicine

Consultant Nephrologist

Mayo Clinic

Jacksonville

FL

Disclosures

NA declares that he has served on advisory boards for Travere Therapeutics and Chinook Therapeutics. He has received research grants from Idorsia, Novartis, and Baxter.

Acknowledgements

Dr Nabeel Aslam would like to gratefully acknowledge Dr Jeremy Levy, Dr Padmanabhan Premkumar, Dr Priyanka Sharma, and Dr Ajay Kumar, previous contributors to this topic.

Disclosures

JL, PP, PS, and AK declare that they have no competing interests.

Peer reviewers

Martin Schreiber, MD

Department Chairman

Nephrology and Hypertension

Cleveland Clinic Foundation

Cleveland

OH

Disclosures

MS declares that he has no competing interests.

Patrick Naish, MB, FRCP

Teaching Fellow

Keele University Medical School

Keele

UK

Disclosures

PN declares that he has no competing interests.

Richard Banks, MBBS, FRCP, MD

Consultant Nephrologist

Gloucestershire Royal Hospital

Gloucester

UK

Disclosures

RB declares that he has no competing interests.

Mark Thomas, BSc, MBBS, MD, FRCP

Consultant Nephrologist

University Hospitals Birmingham

Birmingham

UK

Disclosures

MT declares that he has no competing interests.

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

Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 Clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021 Oct;100(4s):S1-276.Full text  Abstract

Sethi S, De Vriese AS, Fervenza FC. Acute glomerulonephritis. Lancet. 2022 Apr 23;399(10335):1646-63. Abstract

Walters GD, Willis NS, Cooper TE, et al. Interventions for renal vasculitis in adults. Cochrane Database Syst Rev. 2020 Jan 13;(1):CD003232.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Patient information

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  • Calculators

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