Renal biopsies were carried out on 229 dogs using an echo-assisted, semi-automatic method. Complications arising after the biopsy were also evaluated. The biopsies were examined for the accuracy of diagnosis and the presence of histologically demonstrable primary renal pathologies. A retrospective study of the observed lesions and parenchymal echogenicity showed a correlation between these factors involving the tubulo-interstitial compartment. Histopathological renal lesions and their correlation with laboratory methods are the only parameters that allow a correct diagnostic, prognostic, and therapeutic work-up in cases of clinical kidney disease in canines.