Step 1: Is it a kidney disease? Step 2: Is it a glomerular or non-glomerular disease? Determine the type of pathology if available. Step 3: What type of syndrome is it? Step 4: What kind of primary disease is it and is renal function normal? Is it kidney disease 1, hematuria, edema, back pain, polyuria, frequent urination and so on are common symptoms of kidney disease. However, the above symptoms do not indicate that the kidneys are sick. 2.Superior symptoms + abnormal urine routine (proteinuria, hematuria, tubular urine, leukocyturia). 3.Superior symptoms + abnormal kidney function. Any one of the above 2 or 3 can be considered as kidney disease. Hematuria, divided into hematuria and microscopic hematuria. Naked eye hematuria urine is blood or wash water or with blood clots. True hematuria and pseudohaematuria: microscopic hematuria: centrifugal residue RBC ≥ 3 / HPF; or cattle pack Wahl’s count disk count RBC ≥ 8,000 / ml; or hourly RBC excretion rate of > 100,000; or Addis’ count RBC > 500,000 / 12h, any of the above are true hematuria. True hematuria is a lesion of the kidney, ureter, bladder, prostate and urethra, but pseudohaematuria should be excluded. False hematuria: ① urine color like hematuria, not hematuria, such as paroxysmal sleep hemoglobinuria, the patient’s urine was soy sauce or coffee color; certain foods (such as beets, tomato leaves, pigments) can make the urine red; certain drugs (rifampicin, dalantin, phenothiazine, etc.) can also make the urine red, but check the urine without RBCs to identify. ② transient hematuria, such as pollen, chemicals or drugs caused by the person, after strenuous exercise, viral infections (such as colds, etc.) can also occur, only 1 ~ 2 times urine RBC ≥ 3 / HPF, many times negative, usually of no significance. ③ Fake hematuria, some people intentionally mix blood into the urine of fake hematuria, exclude the method is to pay attention to leave a specimen. Contaminated hematuria: hematuria caused by contaminated urine specimen during women’s menstruation. None of the above pseudohematuria is a kidney disease. Only true hematuria is considered to be renal disease. Edema, in addition to glomerulopathy, can also be seen in cardiac, hepatic, endocrine, malnutrition edema. Cardiac edema should have a history of cardiac disease, evidence of heart failure, and swelling in the afternoon or evening, and reduced the next morning for identification. Hepatic edema should have a history of liver disease, abnormal liver function, and edema that is extended to the limbs after the appearance of ascites. Endocrine edema is more common in women with endocrine disease, and the edema does not change significantly in 24 hours without obvious depression when pressed. Dystrophic edema, there should be wasting and other signs of malnutrition, and low plasma albumin. Differential points: urine routine with or without proteinuria. Renal edema: Mostly caused by glomerular disease or other diseases leading to glomerular damage, edema in the loose tissues at the main, to the eyelids and lower limbs, and the morning is very much, the afternoon or evening to reduce, accompanied by proteinuria, hematuria or granular tubular type. If the edema patient urine routine is normal, basically can rule out kidney disease. Low back pain: In addition to kidney disease, lumbar muscle strain, lumbar transverse syndrome, lumbar intervertebral disc herniation, lumbar spondylolisthesis and gynecological diseases. Kidney disease can be seen kidney stones, obstructive nephropathy, huge pyelonephritis, pyelonephritis, acute and chronic glomerulonephritis, renal vein thrombosis, nephrotic syndrome, nephrocytoma, and perinephric inflammation, but renal disease caused by low back pain should have the following characteristics: ① in the spine rib angle pressure point or rib waist pressure point or upper ureteral pressure point pressure; ② urinary routine has obvious abnormalities; ③ renal ultrasound, renal venography (IVP) has a positive finding, furthermore, the renal venous imaging (IVP) has a positive finding, and the renal venous imaging (IVP) has a positive finding. (iii) renal ultrasound, renal venography (IVP) has positive findings, and further CT examination is feasible. If there is no pain in the above three pressure points, urine routine is normal, and there is no abnormality in renal ultrasound and IVP, basically renal disease can be ruled out. Polyuria: refers to 24-hour urine output more than 2500ml, caused by a variety of reasons, non-renal uremia, hyperglycemic diuresis, primary aldosteronism, primary hyperparathyroidism, psychiatric factors, recovery from heart failure. Renal chronic interstitial nephropathy, acute tubular necrosis recovery, hypokalemic nephropathy, renal arteriosclerosis, hypercalciuric nephropathy, etc. Renal polyuria urine routine abnormalities or increased urinary calcium or amino acid content for identification.