Approach to the patient with rapidly progressive glomerulonephritis

Research output: Chapter in Book/Report/Conference proceedingChapter


Mr. A, a 68-year-old male with no history of renal disease, was evaluated for upper respiratory symptoms including cough and postnasal drip. A 10-day course of amoxicillin was prescribed for presumed sinusitis. After 2 weeks, his symptoms did not improve, and levofloxacin was started. One month after the initial presentation, he presented to the emergency department with progressive dyspnea, abdominal pain, and nausea. Serum creatinine level is 7.1 mg/dL (1 month ago, serum creatinine was 1.0 mg/dL), and he is admitted to the hospital for urgent evaluation. On exam, he is afebrile, and blood pressure is 162/90 mmHg. Scattered bilateral pulmonary crackles were noted on exam, and chest X-ray revealed bilateral nodular pulmonary infiltrates. Urinalysis showed 3+ protein with renal epithelial cells, granular casts, 50 red blood cells (RBCs) per high power field (HPF) with many dysmorphic RBCs, and RBC casts on microscopy.

Original languageEnglish (US)
Title of host publicationClinical Decisions in Nephrology, Hypertension and Kidney Transplantation
PublisherSpringer New York
Number of pages8
ISBN (Electronic)9781461444541
ISBN (Print)1461444535, 9781461444534
StatePublished - Nov 1 2013

ASJC Scopus subject areas

  • General Medicine


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