Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- presença de fatores de risco
- edema
- urina espumosa
- hipertensão
- linhas de Muehrcke
- xantelasma e xantoma
Другие диагностические факторы
- índice de massa corporal no 95º percentil ou maior
- linfadenopatia
- erupção cutânea
- lesões orais
- cicatriz da nefrectomia
Факторы риска
- sexo masculino
- raça negra
- história familiar de GESF
- abuso de heroína
- uso de medicamentos causadores conhecidos
- infecção viral crônica
- rim solitário
- doença renal preexistente
- transplante de rim
- isquemia renal aguda
- obesidade
Диагностические исследования
Исследования, которые показаны в первую очередь
- ureia sérica
- creatinina
- taxa de filtração glomerular (TFG)
- urinálise com microscopia
- razão proteína/creatinina na urina
- coleta de urina de 24 horas para dosagem de proteína
- albumina sérica
- perfil lipídico sérico
Исследования, проведение которых нужно рассмотреть
- ensaio de imunoadsorção enzimática (ELISA) sérico para HIV
- contagem de CD4 e estudos de carga viral
- reação em cadeia da polimerase do DNA do parvovírus
- reação em cadeia da polimerase do DNA para citomegalovírus
- sorologias de hepatites B e C
- fator antinuclear, anti-DNA de fita dupla
- eletroforese de proteínas séricas e urinárias
- biópsia renal
Алгоритм лечения
glomeruloesclerose segmentar focal (GESF) primária
glomeruloesclerose segmentar focal (GESF) secundária
Составители
Авторы
Manish Suneja, MD, FASN, FACP
Professor
Department of Internal Medicine
Division of Nephrology
University of Iowa Hospitals and Clinics
Iowa City
IA
Раскрытие информации
MS receives royalties from McGraw-Hill as an editor of the book DeGowin's Diagnostic Examination.
Выражение благодарностей
Dr Manish Suneja would like to gratefully acknowledge Dr Divya Movva, a previous contributor to this topic.
Раскрытие информации
DM declares that she has no competing interests.
Рецензенты
Catherine Clase, BA, MB, MSC, FRCPC
Associate Professor
Nephrologist
McMaster University
Hamilton
Ontario
Canada
Раскрытие информации
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
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.
Differentials
- Nefropatia membranosa
- Doença de lesão mínima
- Amiloidose
More DifferentialsGuidelines
- KDIGO 2021 Clinical practice guideline for the management of glomerular diseases
- Evidence-based clinical practice guidelines for nephrotic syndrome
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Obesidade - medicamentos e cirurgia
Problemas de peso em crianças
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Taxa de filtração glomerular estimada pela equação de estudo em MDRD rastreável por IDMS
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