A glomerulonephritis is suspected when one of the renal syndromes is encountered. Although some urinary investigations and basic blood tests strengthen the suspicion, a combination of a renal biopsy (for histology) and more advanced blood tests is usually required for an accurate aetiological diagnosis. If definite therapy is considered, such a diagnosis is usually required.

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Basic investigations

Urinary investigations:

• Urinary dipstick (tests for blood and protein in the urine)
• Midstream collection for microscopy & culture (to exclude infection)
• 24 hour collection for creatinine clearance & protein excretion

Basic blood tests:

• Renal functions
• Serum albumin & cholesterol

Renal biopsy:
Renal biopsies are not routinely performed on all patients. The basic principle is to reserve this invasive procedure for situations where the result is likely to affect the patient’s management, or if there is diagnostic uncertainty regarding the renal pathology and the histology is likely to be of paramount importance in the diagnostic work up. It is, for example, completely acceptable to diagnose diabetic nephropathy (a very common diagnosis worldwide) in the absence of histology.

Accepted indications for renal biopsies in patients with suspected glomerulonephritis are:

Advanced blood tests:

These tests are usually requested and interpreted in association with the renal syndrome, histology and other special investigations.

Examples include:

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