Usually you begin by seeing your family doctor (GP). They will ask for a sample of your urine, and may also take a blood sample for testing.
Depending on the results of these tests, you’ll be referred to hospital to see a doctor who specialises in diagnosing and treating kidney and bladder problems (a urologist).
If you have blood in your urine (haematuria) you may be referred to a ‘one-stop’ haematuria clinic. At this clinic, all the tests needed to make a diagnosis can often be carried out at the same time and you can go home on the same day.
At the hospital, you’ll see a urologist or a specialist nurse who will ask you about your symptoms and general health. They’ll also examine you and arrange some of the following tests:
This test can be very helpful in diagnosing cancer of the kidney. It uses sound waves to build up a picture of the inside of the tummy (abdomen), including the kidneys. It’s a painless test and only takes a few minutes. Once you’re lying comfortably on your back, a gel is spread onto your abdomen. A small device, which produces sound waves, is rubbed over the area. The sound waves are turned into a picture by a computer.
Ultrasound can be used to look for changes in the shape of the kidneys. It can help to show if a lump is a cyst (a fluid-filled lump) or a tumour. It can also be used to show the position of a cancer and measure its size.
IVU (intravenous urogram) or IVP
This test shows up anything unusual in the kidneys or urinary system. It’s done in the hospital x-ray department and takes about an hour. A dye is injected into a vein in your arm, which travels through the bloodstream to the kidneys. The doctor can watch on a screen how the dye passes through the kidneys and can pick up any problems. The dye will probably make you feel hot and flushed for a few minutes, but this feeling goes away after a short time.
This procedure is often combined with a CT scan (see below) and is known as a CT urogram.
CT (computerised tomography) scan
A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. The scan takes 10–30 minutes and is painless. It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.
You’ll probably be able to go home as soon as the scan is over.
These are often taken to check the health of your heart and lungs.
You may have this test to check the lining of your bladder if you have blood in your urine.
It’s usually done under local anaesthetic and takes about 20 minutes. A doctor or nurse will gently pass a thin, flexible tube with a camera and light on the end (cystoscope) through the urethra and into the bladder. This allows them to look at the whole lining of the bladder and urethra.
You may have some soreness or mild pain when you pass urine for the first couple of days after the test. There aren’t usually any other effects.
MRI (magnetic resonance imaging) scan
This test uses magnetism to build up a detailed picture of areas of your body. The scanner is a powerful magnet, so you may be asked to complete and sign a checklist to make sure it’s safe for you.
The checklist asks about any metal implants you may have, such as a pacemaker, surgical clips or bone pins. You should also tell your doctor if you’ve ever worked with metal or in the metal industry as very tiny fragments of metal can sometimes lodge in the body. If you do have any metal in your body, it’s likely that you won’t be able to have an MRI scan. In this situation, another type of scan can be used.
Before the scan, you’ll be asked to remove any metal belongings, including jewellery. Some people are given an injection of dye into a vein in the arm, which doesn’t usually cause discomfort. This is called a contrast medium and can help the images from the scan to show up more clearly.
During the test you’ll lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It’s painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It’s also noisy, but you’ll be given earplugs or headphones. You can hear, and speak to, the person operating the scanner.
This is done if you need to have a sample of tissue taken from the kidney (a biopsy). The doctor uses an ultrasound scanner or CT scanner to guide them to the exact area of kidney where the biopsy will be taken.
The doctor will inject some local anaesthetic into the skin to numb the area over the kidney. You’ll then have an ultrasound scan or a CT scan. Using the picture from the scan the doctor gently guides the needle through your skin into the kidney. A small sample of tissue is drawn into the needle before it’s removed. The sample is sent to the laboratory to be examined under a microscope.
You may need to stay in hospital for a few hours, or overnight, after this procedure.
Samples of your blood will be taken to check your general health, the number of cells in your blood (your blood count), and to see how well your kidneys and liver are working.
Waiting for test results
Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend.