The Continued Vital Role of Electron Microscopy in the Diagnosis of Renal Disease/Dysfunction

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Ultrastructural examination remains a crucial diagnostic tool for analysis of renal biopsies, along with light and immunofluorescence microscopy. Several advantages of electron microscopy are the ability to detect most forms of glomerular disease/dysfunction; the ability to examine small, suboptimal, or unusual specimens; and superior resolution that allows the investigator to hunt without preconceived ideas of what he/she is looking for or will find. A few shortcomings must be noted for completeness, including inability to detect disorders without specific ultrastructural signature, biochemical heterogeneity of deposits with similar or identical ultrastructural appearances, and occasional false-negative results in diseases with focal manifestations.