Kidney biopsy

The causes of acute and chronic decline in kidney function are vast. Understanding the underlying diagnosis is essential to slow the progression of the kidney disease or achieve recovery. Detailed clinical assessment and simple investigations can help identify the nature of kidney injury (pre-renal, intrinsic, post-renal). Used appropriately, kidney biopsy has the potential to generate valuable information to aid diagnosis, guide prognosis and management, and identify relapse of intrinsic kidney disease. However, kidney biopsy is an invasive procedure with significant, albeit small, complications because of the risk of bleeding. The decision to proceed should be led by the nephrology team and requires a careful risk–benefit assessment and close discussion with the patient.