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Bilateral renal parenchymal disease
Patient: Male, 74+ years
Chief Concern: Report suggestive of bilateral renal parenchymal disease
Relevant Test Reports:
CBC: Normal
Serum Urea: 41 mg/dl
Serum Creatinine: 0.98 mg/dl
LFT: Normal
Lipid Profile: Normal
Urine R/E and M/E: Normal (Protein, Glucose, Ketones negative)
Microalbumin/Creatinine Ratio: 189.71 mg/dl
tPSA: 0.17 ng/ml
FBS: 93 mg/dl
PPBS: 187 mg/dl
HbA1c: 6.87%
USG Whole Abdomen Findings:
Liver, gall bladder, CBD, pancreas, spleen, ureters, bladder, and prostate: Normal
Kidneys: Both kidneys normal in size, shape, position, and outline
Bilateral cortical echogenicity increased with maintained cortico-medullary differentiation
Multiple small cortical cysts in left kidney, up to 13 mm × 11 mm
No calculus or hydronephrosis on either side
Right kidney size: 100 mm
Left kidney size: 92 mm
Impression:
Bilateral renal parenchymal disease
Patient’s Questions / Concern:
Is this condition serious?
Is it curable?
Kindly advise further treatment and follow-up.
Answers (17)
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Relax - his reports are actually reassuring. Creatinine 0.98 with normal urea, normal urine and no obstruction means kidney function is preserved at 74. "Bilateral renal parenchymal disease" on ultrasound here is age-related plus early diabetic change, and the raised microalbumin/creatinine ratio is the real signal. The small left kidney cysts are harmless. It is not reversible but it is very controllable - the aim is to stop it from progressing.
Next Steps
Keep HbA1c under 6.5 and BP under 130/80, salt low, protein moderate, and strictly no painkillers like ibuprofen or diclofenac. He needs a check on whether an ACE inhibitor/ARB or SGLT2 inhibitor should be started - that is what protects kidneys long term. Repeat creatinine, eGFR and urine microalbumin every 6 months. Book a consult with me on Practo with the full file and I will set the exact medicine plan.
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine.
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Control HbA1c by diet, exercise and Medications
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There are many kidney biochemical parameters which are disturbed. It has not reached a stage of dialysis.
I think you should be under consultation of a Nephrologist regularly.
Not to be treated by Tele-consultation.
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Himms is the place u need. Not a open platform
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Starting of a serious issue may be. Need more medical history. Kindly consult with me on 94 two six 86 seven eight 96.
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His HbA1c is in the diabetic range.This is causing microalbuminuria which is slightly high.since creatinine,urea etc are normal it indicates good renal function.The renal cortical cysts are normal. So he has to monitor his morning urine urinary microalbumin and see if it is becoming higher .control hba1c by diet exercise and medication if necessary..cortical hyper echogenecity indicates renal parenchymal disease.
Next Steps
Monitor FBs ppbs hba1 c every 3 months
Measure urinary micro albumin
If creatinine .,e gfr.
Health Tips
,etc are worsening it is bad prognosis
But now all these are ok.if it deteriorates see a nephrologist At present prognosis is good.control diabetes and hypertension
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It is curable, consult a Nephrologist offline.
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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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in regular followup and treatment it may not progress further
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This condition is due to uncontrolled Diabetes mellitus and htn. Now its in mild form and start nephroprotective drugs like arbs inhibitors .or you can consult directly with nephrologist .
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Do connect and consult
Will help you
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Please consult
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Dr. Sachin Bhiwaji Sanap
General Practitioner
8 yrs exp
Hingoli
It is treatable please consult any Gen surgeon or urologist in person
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Dr. Reesha Varshney
General Physician
1 yrs exp
Bareilly
Yes it is curable
You need some Lifestyle modification and some regular medicines
Connect with me I will help you out
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.