Parenchymal renal disease can be considered anatomically under the headings of glomerular, tubular, tubulointerstitial, and vascular disease. Most patients present with a clinical syndrome of nephron injury. The clinical features of parenchymal renal disease frequently depend on the component of the kidney that is affected—for example, glomerulonephritis presents with worsened kidney function, hypertension, hematuria, proteinuria, and red cell casts. Tubulointerstitial nephritis presents with azotemia, pyuria and/or white cell casts.