1.Why should kidney puncture biopsy be performed? In clinical practice, many kidney diseases cannot be clearly diagnosed by clinical indicators alone, and there are many shortcomings in judging the prognosis and other aspects. Kidney biopsy is good for clear diagnosis, understanding pathological types, guiding treatment, judging prognosis, buying time for patients and avoiding less detours. For example, in patients with allergic purpura nephritis, their clinical manifestations are all proteinuria and hematuria, but their pathological types can be divided into 6 grades, and the treatment plan for each grade of lesion is different. Therefore, renal biopsy is necessary for some patients with kidney disease. Gao Xiguang, Department of Pediatrics, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine 2. Is renal puncture harmful to the kidneys? Generally, doctors determine the need for kidney puncture in patients, mostly after strictly grasping and understanding the condition, according to the requirements of indications and contraindications. In addition, the kidney has good storage capacity and repair ability, and the kidney can be repaired within a short time after kidney puncture, so kidney puncture will not aggravate the damage of the kidney. Although renal puncture is an invasive examination method, with the continuous improvement of renal biopsy operation, guidance technology and care methods, the incidence of complications of renal biopsy has become less and less, and renal puncture has become a safer puncture technique. 3, which patients need to perform renal puncture biopsy? The indications for renal puncture biopsy are: ① allergic purpura nephritis, the need to understand its pathological type, to understand the presence of crescent formation, the proportion of crescent, based on the pathological type to determine the treatment plan patients; ② nephrotic syndrome, hormone therapy is not sensitive or suspected that its pathological type is heavy children; ③ for clinically unexplained hematuria or suspected IgA nephropathy, after excluding the non-glomerular source of hematuria, renal puncture biopsy should be performed to clarify the diagnosis; ④ those with acute glomerulonephritis with insignificant efficacy after 4 weeks of treatment; ⑤ renal damage caused by systemic diseases such as systemic lupus erythematosus, diabetes mellitus, polyarteritis nodosa, amyloidosis, etc.; ⑥ unexplained and persistent proteinuria; ⑦ those who are considered to have tubulointerstitial lesions by various clinical examinations. (8) In cases of renal insufficiency, when there is difficulty in diagnosing and determining the treatment plan, especially in acute onset and suspected acute nephritis, renal aspiration biopsy should be performed as early as possible to confirm the diagnosis and facilitate the development of a treatment plan; (9) In cases of suspected rejection after renal transplantation, or when the diagnosis of rejection is ineffective with treatment, or when the original renal disease is suspected to have recurred, renal aspiration biopsy should be performed; (10) Other, such as unexplained hypertension, the condition and the treatment of which is not relevant to the treatment If the condition and treatment require serial renal puncture biopsies to correct the diagnosis and revise the treatment plan, such as unexplained hypertension.