Diagnostic testing in glomerular disease

Glomerular diseases are among the hardest diseases to diagnose. They can affect multiple organs (and thereby cause multiple symptoms) or only the kidney. While specific diseases may have a "classic" presentation, the overlap among presentations is considerable, and often the only way to diagnose a glomerular disease is by a kidney biopsy. There are many diagnostic tests that can help diagnose a glomerular disease, and more are being identified. This chapter focuses on serologic and urine tests that can be used to help diagnose a glomerular disease. The main diagnostic considerations of the two glomerular syndromes, nephritic and nephrotic, are discussed individually. In a patient with nephritic or nephrotic syndrome, clinical judgment based on the presentation will always be needed to determine if other diagnostic tests should be sent off in place of a kidney biopsy or along with a kidney biopsy.