There are various ways by which a patient with renal disease can present as either an initial outpatient or an inpatient consultation. Some patients can present with incidental hematuria and/or proteinuria. Symptoms generally vary but are more commonly noted with advanced stages of chronic kidney disease. A systematic, well organized approach is of utmost necessity in arriving at the correct diagnosis. A multitude of laboratory and ancillary studies, including a percutaneous renal biopsy (performed when necessary), are available to arrive at the right diagnosis. An algorithmic approach to hematuria and proteinuria is also presented.