Editing Kidney (section)

=== Diagnosis ===
Many renal diseases are diagnosed on the basis of a detailed [[medical history]], and [[physical examination]].<ref>{{cite journal |vauthors=Gaitonde DY |title=Chronic Kidney Disease: Detection and Evaluation |journal=Am Fam Physician |date=15 December 2017 |volume=12 |issue=96 |pages=776–783 |url=https://www.aafp.org/afp/2017/1215/p776.html |access-date=1 March 2021 |archive-date=26 February 2021 |archive-url=https://web.archive.org/web/20210226140126/https://www.aafp.org/afp/2017/1215/p776.html |url-status=live }}</ref> The medical history takes into account present and past symptoms, especially those of kidney disease; recent infections; exposure to substances toxic to the kidney; and family history of kidney disease.

[[Renal function|Kidney function]] is tested by using [[blood test]]s and [[Clinical urine tests|urine tests]]. The most common blood tests are [[creatinine]], [[urea]] and [[electrolyte]]s. Urine tests such as [[urinalysis]] can evaluate for pH, protein, glucose, and the presence of blood. Microscopic analysis can also identify the presence of [[urinary cast]]s and crystals.<ref name="uptodate.com"/> The [[glomerular filtration rate]] (GFR) can be directly measured ("measured GFR", or mGFR) but this rarely done in everyday practice. Instead, special equations are used to calculate GFR ("estimated GFR", or eGFR).<ref>{{cite journal |title=KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease |journal=Kidney Int Suppl |date=2013 |volume=3 |pages=1–150 |url=https://kdigo.org/guidelines/ckd-evaluation-and-management/ |access-date=2021-01-25 |archive-date=2019-05-01 |archive-url=https://web.archive.org/web/20190501124111/https://kdigo.org/guidelines/ckd-evaluation-and-management/ |url-status=live }}</ref><ref name="uptodate.com">{{cite web|vauthors= Post TW, Rose BD|veditors= Curhan GC, Sheridan AM|title= Diagnostic Approach to the Patient With Acute Kidney Injury (Acute Kidney Failure) or Chronic Kidney Disease|website= www.uptodate.com|date= December 2012|url= http://www.uptodate.com/contents/diagnostic-approach-to-the-patient-with-acute-kidney-injury-acute-renal-failure-or-chronic-kidney-disease|access-date= 2016-12-19|archive-date= 2015-11-10|archive-url= https://web.archive.org/web/20151110144346/http://www.uptodate.com/contents/diagnostic-approach-to-the-patient-with-acute-kidney-injury-acute-renal-failure-or-chronic-kidney-disease|url-status= live}}</ref>

==== Imaging ====
[[Renal ultrasonography]] is essential in the diagnosis and management of kidney-related diseases.<ref name=Hansen2015>Content initially copied from: {{cite journal | vauthors = Hansen KL, Nielsen MB, Ewertsen C | title = Ultrasonography of the Kidney: A Pictorial Review | journal = Diagnostics | volume = 6 | issue = 1 | pages = 2 | date = December 2015 | pmid = 26838799 | pmc = 4808817 | doi = 10.3390/diagnostics6010002 | doi-access = free }} [https://creativecommons.org/licenses/by/4.0/ (CC-BY 4.0)] {{Webarchive|url=https://web.archive.org/web/20171016050101/https://creativecommons.org/licenses/by/4.0/ |date=2017-10-16 }}</ref> Other modalities, such as [[CT scan|CT]] and [[magnetic resonance imaging|MRI]], should always be considered as supplementary imaging modalities in the assessment of renal disease.<ref name=Hansen2015/>

==== Biopsy ====
The role of the renal biopsy is to diagnose renal disease in which the etiology is not clear based upon noninvasive means (clinical history, past medical history, medication history, physical exam, laboratory studies, imaging studies). In general, a renal pathologist will perform a detailed morphological evaluation and integrate the morphologic findings with the clinical history and laboratory data, ultimately arriving at a pathological diagnosis. A renal [[pathologist]] is a physician who has undergone general training in anatomic pathology and additional specially training in the interpretation of renal biopsy specimens.

Ideally, multiple core sections are obtained and evaluated for adequacy (presence of glomeruli) intraoperatively. A pathologist/pathology assistant divides the specimen(s) for submission for light microscopy, immunofluorescence microscopy and electron microscopy.

The pathologist will examine the specimen using light microscopy with multiple staining techniques (hematoxylin and eosin/H&E, PAS, trichrome, silver stain) on multiple level sections. Multiple immunofluorescence stains are performed to evaluate for antibody, protein and complement deposition. Finally, ultra-structural examination is performed with electron microscopy and may reveal the presence of electron-dense deposits or other characteristic abnormalities that may suggest an etiology for the patient's renal disease.