最后审阅: 13 四月 2021
最后更新: 18 十二月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 胁腹痛
  • 肋脊角压痛
  • 发热
  • 出现新的或不同于之前的肌痛,或者流感样症状
  • 危险因素
  • 恶心
  • 呕吐

其他诊断因素

  • 耻骨上压痛
  • 心动过速
  • 低血压

危险因素

  • 泌尿道感染
  • 糖尿病
  • 压力性尿失禁
  • 尿路异物(例如结石、导管
  • 解剖性/功能性泌尿系统异常
  • 免疫抑制状态(例如,HIV、移植、化疗、使用皮质类固醇
  • 妊娠
  • 频繁性交
  • 母亲具有泌尿道感染病史
  • 新的性伴侣
  • 使用杀精剂
  • 年龄 18~50 岁
  • 年龄 60 岁以上

诊断性检查

首要检查

  • 尿液分析
  • 尿培养和药敏
  • 全血细胞计数
  • 红细胞沉降率
  • C 反应蛋白
  • 尿素和电解质
  • 肌酐
  • 血培养(在医院

需考虑的检查

  • 肾脏超声
  • 增强 CT 检查
  • 磁共振成像 (MRI)

治疗流程

撰稿人

Consultant Renal Physician

Honorary Associate Professor

Nephrology Department

Leeds Teaching Hospitals NHS Trust

Leeds

UK

利益声明

AL is Associate Clinical Director of NIHR Leeds In-Vitro Diagnostics Co-operative, Co-Chair of UK Kidney Research Consortium Renal Clinical Study Group, Member of Kidney Research UK Research Grant Committee, Committee Member of NICE Kidney Injury Clinical Guideline Update 2018-20, Committee Member of NICE Diagnostic Assessment for Point of Care Creatinine Testing 2018-19. AL attended the Acute Dialysis Quality Initiative Meeting in San Diego 2018 (accommodation expenses); AL was a speaker at the AKI & CRRT Conference in San Diego 2019 (travel and accommodation expenses), the AKI Conference in Coventry 2019 (travel expenses), and the NIHR AKI and Sepsis Meeting in Leeds 2019 (no expenses).

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Lynda A. Frassetto, MD

Professor of Medicine

Division of Nephrology

University of California

San Francisco

CA

LAF declares that she has no competing interests.

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Consultant Nephrologist

The Hillingdon Hospital NHS Foundation Trust

London

UK

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SG declares that she has no competing interests.

Section Editor, BMJ Best Practice

Consultant in Paediatric Emergency Medicine

Royal London Hospital

London

UK

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TD declares that she has no competing interests.

Section Editor, BMJ Best Practice

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EQ declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

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SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Lead Section Editor, BMJ Best Practice

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RW declares that she has no competing interests.

Comorbidities Editor, BMJ Best Practice

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AS declares that she has no competing interests.

Drug Editor, BMJ Best Practice

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AM declares that he has no competing interests.

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