Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- hematúria
- edema
- hipertensão
Other diagnostic factors
- oligúria
- anorexia
- náuseas
- mal-estar
- perda de peso
- febre
- erupção cutânea
- artralgia
- hemoptise
- dor abdominal
- faringite
- hipervolemia
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
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
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
Treatment algorithm
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
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.
Differentials
- Nefrolitíase
- Câncer de bexiga
- Câncer renal
More DifferentialsGuidelines
- KDIGO clinical practice guideline for antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis
- KDIGO clinical practice guideline for the management of lupus nephritis
More GuidelinesPatient information
Nefrolitíase
Infecção renal
More Patient informationCalculators
Taxa de filtração glomerular estimada pela equação CKD-EPI
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