As with the rest of medicine, important clues as to the cause of any symptom are gained in the history and physical examination.
Laboratory tests are almost always aimed at: urea, creatinine, electrolytes, and urinalysis, which is frequently the key test in suggesting a diagnosis.
More specialized tests can be ordered to discover or link certain systemic diseases to kidney failure such as hepatitis b or hepatitis c, lupus serologies, paraproteinemias such as amyloidosis or multiple myeloma or various other systemic diseases that lead to kidney failure. Collection of a 24-hour sample of urine can give valuable information on the filtering capacity of the kidney and the amount of protein loss in some forms of kidney disease. However, 24-hour urine samples have recently, in the setting of chronic renal disease, been replaced by spot urine ratio of protein and creatinine.
Other tests often performed by nephrologists are:
- Renal biopsy, to obtain a ''tissue diagnosis'' of a disorder when the exact nature or stage remains uncertain.;
- Ultrasound scanning of the urinary tract and occasionally examining the renal blood vessels;
- CT scanning when mass lesions are suspected or to help diagnosis nephrolithiasis;
- Scintigraphy (nuclear medicine) for accurate measurement of renal function (rarely done), and MAG3 scans for diagnosis of renal artery disease or 'split function' of each kidney;
- Angiography or Magnetic resonance imaging angiography when the blood vessels might be affected
Further Reading
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