The role of kidney biopsy in the diagnosis of renal disease and renal masses

Renal biopsy has become a fundamental diagnostic tool both in nephrology, for the diagnostic assessment of many renal diseases, and in oncology, for the characterization of renal masses. A number of different nephrologic diseases can show a similar clinical and laboratory pattern but the histopathological features are different. Biopsy is required as different histological entities are associated with different therapeutic protocols and with different prognoses when considering the renal function. Biopsy of renal masses are becoming more frequent, as this procedure is required in candidates to non surgical treatments, i.e., radiofrequency ablation, and in patients for whom partial nephrectomy may be preferred. The correct patients selection and preparation, the use of modern bioptic devices, the possibility of a real time monitoring of the procedure by means of ultrasound, significantly decreased both patient discomfort and the complication rate of this invasive procedure. Until few years ago renal biopsy was performed in few selected centers, while now it is more widespread but nevertheless it requires a multidisciplinary team where the nephrologist, the radiologist and the pathologist are involved. All these physicians are essential part of the team and are required for the procedure and for the correct diagnostic interpretation.