Focal segmental glomerulosclerosis laboratory findings: Difference between revisions
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===Renal Ultrasound=== | ===Renal Ultrasound=== | ||
Routine renal ultraound is recommended in patients with FSGS to monitor kidney size and echogenicity.<ref name="pmid23871408">{{cite journal| author=Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH et al.| title=KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis. | journal=Am J Kidney Dis | year= 2013 | volume= 62 | issue= 3 | pages= 403-41 | pmid=23871408 | doi=10.1053/j.ajkd.2013.06.002 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871408 }} </ref> | |||
===Renal Biopsy & Electron Microscopy=== | ===Renal Biopsy & Electron Microscopy=== | ||
Renal biopsy and electron microscopy are required for the diagnosis and management of FSGS.<ref name="pmid23871408">{{cite journal| author=Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH et al.| title=KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis. | journal=Am J Kidney Dis | year= 2013 | volume= 62 | issue= 3 | pages= 403-41 | pmid=23871408 | doi=10.1053/j.ajkd.2013.06.002 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23871408 }} </ref> | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
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*Dysmorphic red blood cells | *Dysmorphic red blood cells | ||
*Fatty casts | *Fatty casts | ||
==References== | ==References== | ||
Revision as of 00:23, 4 December 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Initial lab-work up should be directed first towards finding a possible etiology for FSGS. HIV testing in patients with new-onset FSGS, especially those with collapsing variant, is a must in all patient. Additionally, monitoring of disease progression by serum creatinine and proteinuria is equally important.
Work-Up
General work-up includes blood work-up, urinalysis, renal ultrasound, and renal biopsy with electron microscopy for the diagnosis and management of FSGS. Genetic testing is currently not recommended.[1]
Blood Work-Up
A comprehensive lab work-up is necessary for all patients with FSGS. Common causes of secondary FSGS, such as HIV, HBV, HCV, and systemic lupus erythematosus (SLE), should also be ruled out:
- Complete blood count (CBC)
- Serum electrolytes
- Serum albumin
- Lipid profile
- Serum creatinine
- Blood urea nitrogen (BUN)
- CD4 count and HIV test (necessary for all patients with FSGS, especially collapsing variant)
- DNA/PCR for parvovirus B19
- CMV test
- Serum complement C3 and C4
- ANA profile
- Titers of antibodies specific for systemic diseases, such as anti-dsDNA
- c-ANCA and p-ANCA
- Serum protein electrophoresis
- Other necessary tests to rule out secondary etiologies, as suggested by history and physical exam
Urinalysis
- Urinalysis with microalbuminuria and urinary creatinine
- Urine culture
- Urinary protein electrophoresis
Renal Ultrasound
Routine renal ultraound is recommended in patients with FSGS to monitor kidney size and echogenicity.[1]
Renal Biopsy & Electron Microscopy
Renal biopsy and electron microscopy are required for the diagnosis and management of FSGS.[1]
Laboratory Findings
Blood
- Anemia
- Hypoalbuminemia
- Abnormal lipid profile
- Increased serum creatinine
Urine
- Proteinuria
- No/microscopic/macroscopic hematuria
- Dysmorphic red blood cells
- Fatty casts
References
- ↑ 1.0 1.1 1.2 Beck L, Bomback AS, Choi MJ, Holzman LB, Langford C, Mariani LH; et al. (2013). "KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis". Am J Kidney Dis. 62 (3): 403–41. doi:10.1053/j.ajkd.2013.06.002. PMID 23871408.