We present the case of a 29-year-old woman with twelve-years history of Wegener's granulomatosis and multiple relapses resulting in chronic kidney disease. The patient was referred to our center for kidney biopsy, after presenting with a relapse of Wegener's disease mainly manifested by rapid progressive glomerulonephritis. Kidney biopsy was obtained and she was treated with intravenous methylprednisolone and oral cyclophosphamide as initial therapy. Histopatological findings are described, followed by a discussion on how it can be used as a tool to established renal prognosis.