Focal segmental glomerulosclerosis laboratory findings: Difference between revisions
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Kidney biopsy is the gold standard to establish the diagnosis of FSGS and determine the subtype of FSGS (see the histological variants of FSGS above). Kidney biopsy will reveal the presence of sclerosis in parts (segmental) of some (focal) glomeruli by light microscopy and diffuse (more than 80 percent) effacement of the foot processes by electron microscopy. | Kidney biopsy is the gold standard to establish the diagnosis of FSGS and determine the subtype of FSGS (see the histological variants of FSGS above). Kidney biopsy will reveal the presence of sclerosis in parts (segmental) of some (focal) glomeruli by light microscopy and diffuse (more than 80 percent) effacement of the foot processes by electron microscopy. | ||
==References== | ==References== | ||
Revision as of 15:54, 11 June 2018
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Focal segmental glomerulosclerosis Microchapters |
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Differentiating Focal segmental glomerulosclerosis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [3]
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.
Laboratory Findings
A comprehensive lab workup 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. Laboratory findings consistent with the diagnosis of focal segmental glomerulosclerosis include:[1]
- CBC
- Anemia
- Lipid profile
- Hyperlipidemia
- Renal function test
- Increased creatinine levels
- Hypoalbuminemia
- Blood urea nitrogen (BUN)
- CD4 count and HIV test
- 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
- Urine analysis
- Proteinuria
- Microscopic hematuria
- Dysmorphic red blood cells
- Fatty casts
- Microalbuminuria and urinary creatinine
- Urine culture
- Urinary protein electrophoresis
Urinalysis
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]
Kidney biopsy is the gold standard to establish the diagnosis of FSGS and determine the subtype of FSGS (see the histological variants of FSGS above). Kidney biopsy will reveal the presence of sclerosis in parts (segmental) of some (focal) glomeruli by light microscopy and diffuse (more than 80 percent) effacement of the foot processes by electron microscopy.
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.