小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 疲劳
- 水肿
- 伴有/不伴呕吐的恶心
- 瘙痒
- 不宁腿
- 厌食
- 感染相关的肾小球疾病
其他诊断因素
- 关节痛
- 前列腺增大
- 泡沫尿
- 尿色加深
- 皮疹
- 呼吸困难
- 端坐呼吸
- 癫痫发作
- 视网膜病变
危险因素
- 糖尿病
- 高血压
- 50 岁以上
- 小儿肾脏疾病
- 吸烟
- 肥胖
- 黑人或西班牙人
- CKD 家族史
- 自身免疫性疾病
- 男性
- 长期使用非甾体抗炎药
- 高尿酸水平
诊断性检查
首要检查
- 肾功能化学指标
- 估算 GFR
- 血清胱抑素 C 和基于胱抑素 C 的 GFR 估算值
- 尿液分析
- 尿白蛋白
- 肾脏超声
需考虑的检查
- 肾脏活检
- 腹部平片
- 腹部 CT 检查
- 腹部 MRI
治疗流程
GFR 分类 G1-G2，无尿毒症
GFR 分类 G3-G4，无尿毒症
GFR 分类 G5，或伴有尿毒症
撰稿人
作者
Manisha Singh, MD
Associate Professor
Division of Nephrology
Department of Internal Medicine
Director Home Dialysis Program
Co-Director M2 Renal Module
University of Arkansas for Medical Sciences
Little Rock
AR
利益声明
MS is an author of a reference cited in this topic.
Michelle W. Krause, MD, MPH
Professor of Medicine
Director, Integrated Medicine Service Line
Vice-Chair for Clinical Operations, Quality, and Efficiency
Department of Internal Medicine
University of Arkansas for Medical Sciences
Central Arkansas Veterans Healthcare System
Little Rock
AR
利益声明
MWK declares that she has no competing interests.
鸣谢
Dr Manisha Singh and Dr Michelle Krause would like to gratefully acknowledge Professor Sudhir V. Shah, a previous contributor to this topic.
利益声明
SVS declares that he has no competing interests.
同行评议者
Robert Toto, MD
Professor
Internal Medicine - Nephrology
Southwestern Medical School
The University of Texas Southwestern Medical Center at Dallas
Dallas
TX
利益声明
RT declares that he has no competing interests.
Guy H. Neild, MD, FRCP, FRCPath
Professor of Nephrology
UCL Division of Medicine
University College London
London
UK
利益声明
GHN declares that he has no competing interests.
鉴别诊断
- 糖尿病性肾脏疾病
- 高血压性肾硬化
- 缺血性肾脏病
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