Potential Causes of Chronic Kidney Disease
| Diagnosis | Clinical Indicators |
|---|---|
| Diabetes mellitus | Classical clinical course of microalbuminuria, followed by clinical proteinuria, hypertension, and then declining GFR. |
| Hypertension | Usually characterized by severely elevated blood pressure readings over a long period, with associated end-organ damage in addition to kidney disease. |
| Nephrotoxic medications | Review prescribed and over-the-counter medications as well as intravenous contrast dye or gadolinium exposure. |
| Systemic lupus erythematosus | Evaluate for photosensitivity, malar/discoid rashes, oral ulcers, arthritis, serositis, neurological symptoms, hematological findings, ANA/dsDNA positive. |
| HIV nephropathy | Signs and symptoms of immunodeficiency; HIV positive on testing. |
| Congestive heart failure | Signs and symptoms of heart failure present. Because fluid overload is common in chronic kidney disease, diagnosis is made through echocardiogram to evaluate systolic and diastolic heart function. |
| Genetic syndromes | Evaluation of family history is suggestive. |
| Hepatorenal syndrome | History or evidence of cirrhosis with resultant portal hypertension, ascites, and renal vasoconstriction. Classically lack significant proteinuria. |
| Nephrolithiasis | Evaluate for history of hematuria and symptoms of renal colic. Long-standing obstruction can cause permanent renal impairment. |
| Benign prostatic hypertrophy | Evaluate male patients for hesitancy, straining, or weak flow during urination and nocturia. Confirm with prostate exam. |
| Glomerulonephritis | Broad category of diseases including postinfectious (streptococcal) as well as various vasculitis diseases. Urinalysis suggestive with presence of red blood cell casts. |
GFR, glomerular filtration rate; ANA, antinuclear antibodies; dsDNA, double-stranded deoxyribonucleic acid; HIV, human immunodeficiency virus.