When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Glomerulonefrite

Última revisão: 13 Feb 2025
Última atualização: 17 Mar 2023

Resumo

Definição

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.

  • Glomerulonefrite images
  • Differentials

    • Nefrolitíase
    • Câncer de bexiga
    • Câncer renal
    More Differentials
  • Guidelines

    • KDIGO clinical practice guideline for glomerular diseases
    • Evidence-based clinical practice guidelines for rapidly progressive glomerulonephritis 2014
    More Guidelines
  • Patient information

    Glomerulonephritis

    Kidney infection

    More Patient information
  • Calculators

    Taxa de filtração glomerular estimada pela equação CKD-EPI

    More Calculators
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer