**3.3 Electron microscopy**

The fixative for EM is 2–3% glutaraldehyde or 1–4% paraformaldehyde. Electron microscopy (EM) aids in visualizing the ultrastructure and cross section of the kidney tissue including the glomerular basement membrane, mesangium, capillary loops, tubulointerstitium, vessels. Immune deposits are also well visualized.

Ideally all three histopathologic examinations discussed above should be performed on all individual patient's specimens received to avoid missed diagnosis. Diagnosis such as light chain-associated disease, IgA nephropathy, anti-glomerular basement membrane disease may be missed without IHC, while diagnosis such as minimal change disease, fibrillary glomerulopathy, immunotactoid glomerulopathy, dense deposit disease, Alports, and thin glomerular basement membrane nephropathy may be missed without an EM.
