Kidney biopsy is very important in the current diagnosis of kidney disease because for chronic glomerular disease, patients in most cases a single successful kidney puncture can provide guidance for a lifetime of treatment, and the total account is still appropriate. Not every kidney disease patient needs kidney puncture, and kidney puncture is a very prudent act, after all, the risks are there. First of all, children with initial nephrotic syndrome can be considered for hormone therapy first, and the effect is ideal for microscopic lesion nephropathy, no need for renal penetration. In adults, if the treatment is ineffective, hormone resistance or dependence, nephroporation is considered, because it may be focal segmental sclerosis or membranous nephropathy, the treatment plan needs to be adjusted, at least the effect of hormones alone is not good. For those who show proteinuria, 24-hour urine protein below 1 gram can be treated directly without kidney puncture. above 1 gram, the effect of ACEI, ARB, etc. is not good, so it is better to kidney puncture before preparing to use hormones. The significance of renal puncture for the guidance of TCM identification treatment, which involves the idea of microscopic identification, is overall less valuable than the guidance of Western medicine treatment. It is not good to generalize whether the pathological types of the same patient can be interconverted, because, for example, in focal segmental sclerosing nephritis, the first kidney puncture may not reach it, because this is originally focal. But in lupus nephritis, the pathological types are transformed, and this has been recognized. This is all there is to say in brief, the specific relevant monographs shall prevail, I only go by memory, not to guarantee accuracy.