小结
定义
病史和体格检查
关键诊断因素
- 血尿
其他诊断因素
- 蛋白尿
- 高血压
- 水肿
危险因素
- IgAN 家族史。
- 男性
- 年龄为 20 岁至 30 岁
- 亚洲人/白人/印第安人血统
- IgA 血管炎
- 慢性肝病
- HIV 感染
诊断性检查
首要检查
- 尿液分析
- 尿液显微镜检查和培养
- 基础生化检查，包括估算的肾小球滤过率 (GFR)
- C3 和 C4 补体水平
- 肾脏超声
- 计算机体层摄象术 (KUB)
- 肾脏活检
需考虑的检查
- 软式膀胱镜检查
- 皮肤活检
治疗流程
低进展风险
中度进展风险
高进展风险
急性肾损伤
撰稿人
作者
Jonathan Barratt, PhD, FRCP
The Mayer Professor of Renal Medicine
Department of Cardiovascular Sciences
University of Leicester
Honorary Consultant Nephrologist
John Walls Renal Unit
Leicester General Hospital
UK
利益声明
JB has consultancies with Alnylam, argenx, Astellas, Calliditas, Chinook, Dimerix, Novartis, Omeros, Travere Therapeutics, Vera Therapeutics and Visterra. He is also an author of a number of references cited in this topic.
See Cheng Yeo, MBBS, M.Med (Int Med), FRCP (London), MD
Adjunct Assistant Professor
Head & Senior Consultant
Department of Renal Medicine
Tan Tock Seng Hospital
Singapore
利益声明
SCY is an author of a reference cited in this topic.
鸣谢
Professor Jonathan Barratt and Dr See Cheng Yeo would like to gratefully acknowledge Dr Hani Bleibel and Dr Chike Nzerue, previous contributors to this topic.
利益声明
HB and CN declare that they have no competing interests.
同行评议者
Richard Lafayette, MD
Associate Professor of Medicine
Nephrology Division
Stanford University Medical Center
Stanford
CA
利益声明
RL declares that he has no competing interests.
Alan Salama, MA, MBBS, PhD, FRCP
Professor of Nephrology
UCL Centre for Nephrology
Royal Free Hospital
London
UK
利益声明
AS declares that he has no competing interests.
鉴别诊断
- IgA 血管炎（以前称为过敏性紫癜 [HSP]）
- 薄肾小球基底膜病
- Alport 综合征
更多 鉴别诊断指南
- KDIGO 2021 年肾小球疾病管理临床实践指南
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明