For nearly 7 decades kidney biopsies have been used in clinical practice to aid in diagnosis, treatment, and prognosis for recovery or progression to kidney failure. The use of kidney biopsies as a prognostic tool was predominantly focused on correlating histology with the outcomes for a specific disease, such as diabetic nephropathy1,2 or IgA nephropathy,3 or a diverse group of kidney diseases.4 Studies also differed in the outcome predicted, as some used only kidney failure,1 while others used kidney failure or 50% reduction in estimated glomerular filtration rate (eGFR).