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__NOTOC__
__NOTOC__
{{Nephrotic syndrome}}
{{Nephrotic syndrome}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}}{{MJ}}
== Overview ==
== Overview ==
[[Proteinuria]] could be measured by 24-hour urine collection. Urine [[protein]] above 3.5 g/day is considered as nephrotic range [[proteinuria]]. Diagnostic study of choice for nephrotic syndrome is kidney [[biopsy]] that reveals the exact type of disease and the its progression.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==


=== Study of choice ===
=== Study of choice ===
* Kidney biopsy is the gold standard test for the diagnosis of nephrotic syndrome.
* [[Proteinuria]] could be measured by 24-hour urine collection. Urine [[protein]] above 3.5 g/day is considered as nephrotic range [[proteinuria]].<ref name="Liebeskind2014">{{cite journal|last1=Liebeskind|first1=David S.|title=Nephrotic syndrome|volume=119|year=2014|pages=405–415|issn=00729752|doi=10.1016/B978-0-7020-4086-3.00026-6}}</ref><ref name="SinhaBagga2012">{{cite journal|last1=Sinha|first1=Aditi|last2=Bagga|first2=Arvind|title=Nephrotic Syndrome|journal=The Indian Journal of Pediatrics|volume=79|issue=8|year=2012|pages=1045–1055|issn=0019-5456|doi=10.1007/s12098-012-0776-y}}</ref>
* The following result of [gold standard test] is confirmatory of [disease name]:
* Kidney [[biopsy]] is the gold standard test for the diagnosis of the underlying cause of nephrotic syndrome.<ref name="pmid3341661">{{cite journal |vauthors= |title=Clinical competence in percutaneous renal biopsy. Health and Public Policy Committee. American College of Physicians |journal=Ann. Intern. Med. |volume=108 |issue=2 |pages=301–3 |date=February 1988 |pmid=3341661 |doi= |url=}}</ref>
** Result 1
'''Relative contrandications of the kidney biopsy:'''
** Result 2
* The [name of the investigation] should be performed when:
*Single [[kidney]]
** The patient presented with symptoms/signs 1. 2, 3.
*Anatomic [[kidney]] abnormalities
** A positive [test] is detected in the patient.
* Small size [[kidneys]] (less than 9 cm), indicative of [[end stage renal disease]]
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* Renal tumor
* The diagnostic study of choice for [disease name] is [name of the investigation].
* Multiple, bilateral renal cysts
* There is no single diagnostic study of choice for the diagnosis of [disease name].
* Active [[infection]] in the [[kidney]] or on the [[skin]] over the biopsy side
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
* Uncorrectable [[bleeding diathesis]]
* [Disease name] is mainly diagnosed based on clinical presentation.
* Severe uncontrolled [[hypertension]]
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison of various diagnostic studies for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
|}
<small> ✔= The best test based on the feature </small>
 
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
* Result 1
* Result 2
 
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
 
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
** Criteria 1
** Criteria 2
** Criteria 3
 
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


* [[Hydronephrosis]]
* Uncooperative patient


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
 
{{WS}}
[[Category:Medicine]]
[[Category:Nephrology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]

Latest revision as of 22:57, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]

Overview

Proteinuria could be measured by 24-hour urine collection. Urine protein above 3.5 g/day is considered as nephrotic range proteinuria. Diagnostic study of choice for nephrotic syndrome is kidney biopsy that reveals the exact type of disease and the its progression.

Diagnostic Study of Choice

Study of choice

  • Proteinuria could be measured by 24-hour urine collection. Urine protein above 3.5 g/day is considered as nephrotic range proteinuria.[1][2]
  • Kidney biopsy is the gold standard test for the diagnosis of the underlying cause of nephrotic syndrome.[3]

Relative contrandications of the kidney biopsy:

References

  1. ↑ Liebeskind, David S. (2014). "Nephrotic syndrome". 119: 405–415. doi:10.1016/B978-0-7020-4086-3.00026-6. ISSN 0072-9752.
  2. ↑ Sinha, Aditi; Bagga, Arvind (2012). "Nephrotic Syndrome". The Indian Journal of Pediatrics. 79 (8): 1045–1055. doi:10.1007/s12098-012-0776-y. ISSN 0019-5456.
  3. ↑ "Clinical competence in percutaneous renal biopsy. Health and Public Policy Committee. American College of Physicians". Ann. Intern. Med. 108 (2): 301–3. February 1988. PMID 3341661.
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