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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Bilateral Renal Parenchymal Condition?

Hi, there! My husband is 47 yrs old. His recent ultrasound showed mild bilateral renal parenchymal disease. He is not diabetic. His blood pressure is normal. It was his gout last year January that revealed malfunction of the kidney. His creatinine level at present is 803.36 umol/l; uric acid is 477.50 umol/l What could be the primary disease? Thanks for your help.
posted on Mon, 7 Jul 2014
Twitter Sun, 5 Apr 2015 Answered on
Twitter Mon, 6 Apr 2015 Last reviewed on
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Diabetologist,  's  Response
Hi,
As you have mentioned about your husband-
1) Age 47yrs.
2) previous history of gout. (Gout: caused by abnormal deposition of crystals of uric acid in joints mainly of foot, great toe joint. there may be normal or high serum uric acid level.)
3) Kidney malfunction in January.
4) Current ultrasound finding of mild bilateral renal parenchymal disease with significantly raised serum creatinine 803.36 umol/l (normal 80 – 115 µmol/L) and marginally raised serum uric acid level 477.50µmol/L (normal 200– 430µmol/L).
5) Absence of diabetes and high blood pressure.

I want to know about -
1) Recent use of nephrotoxic drugs like pain killer medicine.
2) Recent illness.
3) Dehydration due to any cause (loose motions, vomiting, excessive sweating)
As all these factors may aggravate underlying mild kidney dysfunction.

In current scenario I will advise you to consult nephrologist immediately because-
There is Significant elevation in serum creatinine levels and there might be impending need for dialysis.

If waiting for nephrologist, do all these investigations -
1) Serum electrolytes,calcium, phosphorus, vitamin D level, blood urea level, urine examination, urinary protein level.
2) Arterial blood gas levels.
3) Chest x ray.
4) Monitor daily urine out put.
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What Causes Bilateral Renal Parenchymal Condition?

Hi, As you have mentioned about your husband- 1) Age 47yrs. 2) previous history of gout. (Gout: caused by abnormal deposition of crystals of uric acid in joints mainly of foot, great toe joint. there may be normal or high serum uric acid level.) 3) Kidney malfunction in January. 4) Current ultrasound finding of mild bilateral renal parenchymal disease with significantly raised serum creatinine 803.36 umol/l (normal 80 – 115 µmol/L) and marginally raised serum uric acid level 477.50µmol/L (normal 200– 430µmol/L). 5) Absence of diabetes and high blood pressure. I want to know about - 1) Recent use of nephrotoxic drugs like pain killer medicine. 2) Recent illness. 3) Dehydration due to any cause (loose motions, vomiting, excessive sweating) As all these factors may aggravate underlying mild kidney dysfunction. In current scenario I will advise you to consult nephrologist immediately because- There is Significant elevation in serum creatinine levels and there might be impending need for dialysis. If waiting for nephrologist, do all these investigations - 1) Serum electrolytes,calcium, phosphorus, vitamin D level, blood urea level, urine examination, urinary protein level. 2) Arterial blood gas levels. 3) Chest x ray. 4) Monitor daily urine out put.