PT - JOURNAL ARTICLE AU - Katherine L Hull AU - Sherna F Adenwalla AU - Peter Topham AU - Matthew P Graham-Brown TI - Indications and considerations for kidney biopsy: an overview of clinical considerations for the non-specialist AID - 10.7861/clinmed.2021-0472 DP - 2021 Dec 17 TA - Clinical Medicine PG - clinmed.2021-0472 4099 - http://www.rcpjournals.org/content/early/2021/12/13/clinmed.2021-0472.short 4100 - http://www.rcpjournals.org/content/early/2021/12/13/clinmed.2021-0472.full AB - Around 3 million people in the UK have chronic kidney disease and 20% of hospital admissions are complicated by acute kidney injury. Decline in kidney function is not a diagnosis; it is essential to identify and treat underlying causes of acute and chronic kidney disease to either achieve recovery or slow the decline of kidney function. Thorough clinical assessment and simple investigations help determine the category of kidney injury (pre-renal, intrinsic or post-renal) and inform the need for kidney biopsy, which can provide significant information in the evaluation of suspected intrinsic kidney disease, supporting diagnosis, guiding prognosis and management, and identifying disease relapse. The procedure is invasive and not without risk, which although small has the potential to be both organ- and life-threatening. This review outlines roles of kidney biopsy for the non-specialist, with focus of its role in patients with diabetes, lupus, myeloma and in the older patient.