In a patient with known renal issues, experiencing progressive renal failure and hypertension, which antibody should be tested?

In a patient with known renal issues who is experiencing progressive renal failure and hypertension, testing for Anti-glomerular basement membrane antibodies is particularly relevant. The presence of these antibodies indicates a type of glomerulonephritis called Goodpasture's syndrome. This condition is characterized by the destruction of the glomerular basement membrane, which can lead to rapidly progressive renal failure and often presents alongside pulmonary symptoms.

In this scenario, the symptoms of renal failure and hypertension point towards a specific form of renal damage that warrants targeted testing. The presence of Anti-glomerular basement membrane antibodies would suggest an autoimmune mechanism leading to glomerular damage, hence the need for timely diagnosis and treatment.

While the other antibodies listed can be indicative of various autoimmune conditions (such as Anti-smith and Anti-dsDNA being more associated with systemic lupus erythematosus, and Anti-nuclear antibodies serving as a broad marker of autoimmune processes), they do not specifically correlate with the renal pathology described in this context. The focused approach of testing for Anti-glomerular basement membrane antibodies allows healthcare providers to hone in on a likely cause of the patient's renal decline.