[1] Microscopic examination of the tissue can provide information needed to diagnose, monitor or treat problems of the kidney.

[citation needed] In 1951, Danish physicians Poul Iversen and Claus Brun described a method involving needle biopsy which has become the new standard.

[2] Recent widespread availability of real-time imaging guidance using ultrasound or CT scanning having improved perceived safety of the procedure.

This will include careful consideration of patient characteristics and other clinical information obtained from history, examination and other less-invasive investigations.

To decrease the risk of bleeding, patients are usually advised to avoid medicines that impair clotting for one to two weeks before the biopsy.

Desmopressin may be administered intravenously in the hope of reversing the clotting disturbance that accompanies kidney failure (uraemic coagulopathy).

[citation needed] In the case of a native kidney biopsy, the procedure will be performed with the patient lying on their stomach (prone) or on their side (lateral decubitus position).

[citation needed] The site of biopsy is prepared antiseptic solution and sterile drapes are applied.

The person performing the procedure (proceduralist) will wash their hands and don a sterile gown and gloves.

After the site is prepared, the proceduralist injects local anaesthetic into the skin, through the subcutaneous tissue and down to and around the kidney.

A loud click may be heard as the spring-loaded biopsy needle is fired into the kidney to obtain a tissue sample.

A pathologist or pathology scientist may be present at the biopsy to examine the core(s) of kidney tissue for adequacy under a low power microscope.

Blood pressure and urine are frequently monitored to ensure the patient does not have any bleeding complications.

Severe pain is usually an indication of bleeding complication, and may prompt a longer hospital stay and further tests.

Damage to surrounding structures, such as bowel and bladder (more likely with transplant kidney biopsy), can occur.

As with all treatments, there is a risk of allergy to the disinfectant solution, sedation, local anaesthetic and materials (latex gloves, drapes, dressings) used for the procedure.

Finally, the biopsy needle may join an artery and vein in the kidney, resulting in the formation of an arteriovenous fistula.

Rarely, they may result in intermittent bleeding into the urine or may grow in size and threaten to burst.