During a kidney biopsy, also called renal biopsy, your doctor removes a small piece of kidney tissue to examine under a microscope for signs of damage or disease.Your doctor may recommend a kidney biopsy to diagnose a suspected kidney problem, determine the severity of kidney disease or monitor treatment for kidney disease. You also may need a kidney biopsy if you've had a kidney transplant that's not working properly.Most often, a doctor performs a kidney biopsy by inserting a thin needle through the skin, a procedure known as percutaneous kidney biopsy. An imaging device helps the doctor guide the needle into the kidney to remove tissue.