The diagnostic approach to<unk>  includes evaluating the patient for any suspected underlying pathology that could cause a<unk> . Physical examination If the person in the office is being examined by a physician, some physical exam findings consistent with<unk>  include the following: * Edema - This could present as generalized edema (anasarca) or specific swelling of the hands, feet, and/or face. * Other signs of fluid overload - Diffuse rales (crackles) may be heard at bilateral lung bases or diffusely in all lung fields on auscultation with a stethoscope. Jugular venous distention (JVD) may also be appreciated when visualizing the veins of the neck on physical exam. * Elevated blood pressure - Measured at least two separate times with at least two minutes between measurements using a sphygmomanometer or equivalent method. * Abnormal heart sounds - If the underlying cause is cardiac in nature (such as infective endocarditis), then you may appreciate abnormal heart sounds during auscultation of the heart. Laboratory testing If the physician is suspicious of a possible<unk> , then he/she may order some common lab tests including: * Serum electrolytes - The kidney is one of the main regulators of electrolytes in the human body and measuring the different electrolyte levels using either a basic metabolic panel (BMP) or comprehensive metabolic panel (CMP) can be a useful indicator of the underlying pathology. * Serum creatinine - Also measured using a BMP or CMP, creatinine is one of the most important indicators of current kidney function and is used to calculate the glomerular filtration rate (GFR). An elevated creatinine level is considered abnormal and may indicate decreased kidney function. * Blood urea nitrogen (BUN) - Also measured using a BMP or CMP, blood urea nitrogen is an indicator of how much nitrogen is in the blood at the time of the phlebotomy. The kidney is responsible for excreting nitrogenous substances in the urine, so an elevated BUN usually indicates that the kidney is not functioning appropriately. * Urine Analysis (Urinalysis) - After the patient provides a urine specimen, it is sent to the lab for analysis using a variety of methods including urine dipstick testing and microscopic examination. Because the kidney is responsible for making urine, analyzing the urine directly can provide crucial data that can help the physician diagnose<unk> . Some findings on urinalysis that are consistent with<unk>  include red blood cells (hematuria), red blood cell casts, proteinuria, and possibly white blood cells (pyuria). If<unk>  is identified and diagnosed, then it is important for the physician to determine the underlying cause. To do this, he/she may order any of a large variety of relevant lab tests, some of which are included here: * Blood culture - This is the process where a sample of the patient's blood is sent to the microbiology lab to attempt to isolate and grow any bacteria that may be circulating in the blood, in order to identify the pathogen. This is helpful if the physician suspects infection as the underlying cause of the<unk> . * Antinuclear antibody (ANA) titer - ANA is commonly positive in patients who have an underlying autoimmune disease, so this test is useful if the physician suspects an underlying autoimmune disease (refer to the Causes section above for examples) as the cause of the presenting<unk> . If positive, then the physician may order additional tests to determine which autoimmune condition is the cause and how best to treat it. * Antiglomerular basement membrane (anti-GBM) antibody - If positive, this is highly indicative of Goodpasture's syndrome and can be used to guide treatment. * Antineutrophil cytoplasmic antibody (ANCA) - If positive, this indicates that there is likely an underlying vasculitis that may be causing the acute<unk> . * Serum complement (C3 and C4) - Complement factors bind to antibodies to form immune complexes and a decreased serum complement level could indicate that the complement is being consumed at a higher rate due to the formation of immune complexes leading to deposition in the glomerulus of the kidney. Invasive testing A kidney biopsy will provide a fully definitive diagnosis of<unk>  and may also reveal the underlying cause of the<unk>  depending on the underlying pathological process. On biopsy, a patient with<unk>  would show inflammation of numerous glomeruli.
Nephritic syndrome
Nephrotic syndrome  Nephrotic syndrome  1
Papillorenal syndrome
Culture-bound syndrome
Hepatorenal syndrome
Conorenal syndrome
Emmonsiosis
Cardiorenal syndrome