Materials and methods: A retrospective study was conducted on 102 patients who underwent native renal biopsy and, diagnostic renal sonography within 48 hours.

Results: 102 patients underwent ultrasound guided renal biopsy of whom 52% were males and 48% females. The mean age was 44 years with a range of 18–72 years. Of all the patients who underwent renal biopsy, 24.5% had normal appearing kidneys on sonography. Near half of the patients has Grade 1 increase in cortical echogenicity and cortico–medullary differentiation (CMD) was maintained in two third of the patients. Acute tubular necrosis was associated with bulky kidneys. Renal cortical echogenicity had highly significant correlation with loss of CMD, glomerular pathologies, interstitial fibrosis and tubular atrophy and significant correlation with arteriosclerosis. Loss of CMD  had highly significant correlation with glomerular disease, tubular disease, interstitial fibrosis, tubular atrophy and significant correlation with interstitial inflammation and  arteriosclerosis.

Conclusions: Renal biopsy is an indispensable tool to diagnose the pathology behind renal dysfunction. In medical renal disease, renal sonography may be normal or non–specific about etiology, but it definitely plays a role as a good screening tool.