When kidney disease is suspected, healthcare professionals use a combination of medical history, physical examination, laboratory testing, and, when necessary, imaging.
A urine test is often an important first step. It can identify blood, protein, signs of infection, and other abnormalities that may indicate kidney or urinary tract problems.
Blood tests can measure creatinine, which helps clinicians estimate the kidneys' filtering capacity through a calculation called the estimated glomerular filtration rate, or eGFR. Additional tests may be needed to investigate electrolyte disturbances, inflammation, or possible underlying conditions.
Blood pressure measurement is also important because hypertension can contribute to kidney damage, while kidney disease can in turn make blood pressure more difficult to control.
Ultrasound or other imaging may be used when clinicians need to examine the kidneys' structure, assess obstruction, or investigate other possible causes of symptoms. An ordinary abdominal X-ray generally cannot establish kidney inflammation by itself.
In selected cases, a kidney biopsy may be necessary. This procedure involves obtaining a small tissue sample for examination under a microscope. It can help identify specific forms of kidney disease and guide treatment decisions.
Treatment depends on the diagnosis. Some conditions require medication changes, management of an underlying infection, control of blood pressure, or specialist treatment for an immune-mediated disease. Others may need close monitoring and supportive care.
Patients should provide their clinicians with a complete list of prescription medications, over-the-counter pain relievers, supplements, and herbal products. Certain medicines, including some nonsteroidal anti-inflammatory drugs, can contribute to kidney injury in susceptible individuals.
Never stop essential medication or begin treatment based solely on an online image or an unverified social media claim.
Prompt evaluation is especially important when symptoms develop rapidly or kidney function may be deteriorating. Early diagnosis can help clinicians identify treatable causes and reduce the likelihood of further complications.