Evaluation of Renal Disease

This chapter provides an approach to “a child with renal disease” and the “evaluation” that will help in management of the child. Manifestations of renal disease may be vague, nonspecific, and subtle in a child. General guidelines regarding history and physical examination are given. The kidney involvement may be part of a systemic disease, and knowledge of the association between the kidney disease and the involvement of other organs and systems is helpful. Some of these associations are described. Laboratory evaluation is a major component in assessment of renal diseases, as clinical examination is often not enough to make a diagnosis. A few aspects of urine analysis and some glomerular as well as tubular function tests are described. Expert interpretation of renal histology is important in the diagnosis of various renal parenchymal diseases involving glomeruli, the tubulointerstitial region, and small blood vessels. Some histopathological aspects of different renal diseases are given. Also, the role of imaging in making a diagnosis has been emphasized. Technological advances, especially in the area of molecular genetics, have improved our understanding of renal diseases. A brief insight is given in to “renal genetics.”