An evaluation of routine electron microscopy in the examination of renal biopsies was performed. Two renal pathologists, one with and the other without benefit of ultrastructural studies, independently evaluated 213 consecutive renal biopsies. In 11% electron microscopy indicated a substantially different diagnosis and in 36% ultrastructural studies provided important information by substantiating the diagnosis made by light microscopy, establishing a clinically relevant subclassification or documented changes which occurred during the natural course of disease or as a consequence of treatment. The examination of renal biopsy material by electron microscopy in consecutive routine cases contributed to diagnosis and/or patient management in 48% of cases.

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