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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Inhomogeneous Kidney

I had kidney reflux as a child which led to chronic uti s. Eventually it resolved itself. I am now 44 yrs old. The last few yrs i have experienced several uti s. Most recently i have experienced rt flank pain first thing in the morning. As soon as i empty my bladder the pain is gone. I just finished an antibiotic for a uti. My dr had a renal us. The report read that my rt kidney is fairly inhomogeneous with 5mm cortex thinning. Lt kudney appears norm. The radiologist made a final comment that the rt kidney was quite unusual in appearance and suggested a renogram to evaluate kudney function. Is it possible the kidney looks this way from scar tissue?
Fri, 19 Jan 2018
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Oncologist,  's  Response
Hello,
If you want a brief answer then yes.
As you have mentioned you had history of reflux problem from childhood causing chronic and recurrent UTI. This causes recurrent inflammation leading to scar formation. Also reflux can cause damage to renal parenchyma leading to thinning of cortex. This on USG looks as if kidney is inhomogenous and thinned out, which is as seen exactly in your ultrasound.
Next step in such cases is to do a renogram (DTPA scan) to look how each kidney is functioning. As probablity of right kidney to be nonfunctional is high in such cases. In such patients what is usual practice is to go ahead with nephrectomy to avoid recurrent pain and infection. It all depedns on how symptomatic you are, how second kidney is functioning and are you having any other disease which in later life can affect remaining kidney.
So at this juncture I would suggest you to go ahead with renogram and decide further course afterwords.
I will be happy to answer any of your queries.
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Suggest Remedy For Inhomogeneous Kidney

Hello, If you want a brief answer then yes. As you have mentioned you had history of reflux problem from childhood causing chronic and recurrent UTI. This causes recurrent inflammation leading to scar formation. Also reflux can cause damage to renal parenchyma leading to thinning of cortex. This on USG looks as if kidney is inhomogenous and thinned out, which is as seen exactly in your ultrasound. Next step in such cases is to do a renogram (DTPA scan) to look how each kidney is functioning. As probablity of right kidney to be nonfunctional is high in such cases. In such patients what is usual practice is to go ahead with nephrectomy to avoid recurrent pain and infection. It all depedns on how symptomatic you are, how second kidney is functioning and are you having any other disease which in later life can affect remaining kidney. So at this juncture I would suggest you to go ahead with renogram and decide further course afterwords. I will be happy to answer any of your queries.