Renal parenchymal disease is defined as a disease that involves one or more compartments of the renal parenchyma (i.e., the glomeruli, tubules, interstitium, or blood vessels of the kidney).
The percutaneous renal biopsy of native kidneys has been an essential tool in the diagnosis and management of renal disease for over 70 years.
With the evolution of imaging guidance, renal biopsy has become easier and safer.
Ultrasound is the most commonly used tool for imaging guidance.
AIM:
This work aimed to evaluate a standard technique of US-guided PRB for better practice.

PATIENTS AND METHODS:
Patients:
This study was conducted on fifty patients presenting with manifestations of diffuse renal parenchymal disease to the nephrology units of internal medicine and pediatric departments, at Alexandria University hospitals.
Methods:
Detailed history taking including personal data present complaints and past history.
Laboratory investigations with special emphasis on coagulation profile.
Percutaneous renal biopsy:
(1) Pre-biopsy ultrasound scan:
-To assure the presence, the orientation and assess the size and echogenicity of both kidneys.
-To exclude underlying focal pathology.
(2) Ultrasound-guided percutaneous renal biopsy.
-Using real-time ultrasound to trace the trajectory of the needle passing and cutting through the lower pole of the kidney.
(3) Post-biopsy ultrasound scan.
-Immediate, 1 and 2 hours post-procedural.