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We review a controlled numerical approach to quantum impurity problems in realistic geometries, consisting of exactly mapping the complete lattice Hamiltonian onto an equivalent one dimensional system through a unitary transformation. The resulting dimensional and entanglement reduction allows one to study the quantum many-body problem on arbitrary d-dimensional lattices using the density matrix renormalization group (DMRG) method. The real-space resolution allows one to position the impurities at the boundary or bulk of the sample and to study screening effects due to edge or surface modes. We describe how to generalize this approach to multi-impurity problems, discuss applications and possible extensions.