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Child with hydronephrosis. Enlarged kidney. What does it mean and treatment options?

Dear Sir, We would like to know your opinion on below mentioned case of my sister Name: Ms Pooja Jadhav Age:14 She had complaint of Back Pain and doctor advised us for sonography and DTPA RENOGRAM AND SCAN. The Details regarding the reports is as follows: Sonography reports shows that the size of Right Kidney is enlarged: 16 x 7.7 cm, Left Kidney :9.5 x 4.7 cm Echotexture : Gross Hydronephrosis with paper thin cortex for Right Kidney and for left kidney it is normal CMD: Lost in right kidney , Left kidney it is Maintained. Renal Calculi: None (both) Ureter: Undilated (both) Ureteric Calculi: None (both) And DTPA RENOGRAM shows results as follows: QUANTITATIVE DATA: A) Cortical function at 2 min 1. Left Kidney: 65.64% 2. Right Kidney : 34.36% B) Retention at 30 minutes: 1. Left Kidney: 27% 2. Right Kidney: 100% Comments: Left Kidney shows normal perfusion , compensatory cortical function and normal excretion . Right Kidney shows reduced perfusion, residual cortical function and is obstructive in nature. We request you to please go through the details provided and advised us suitably. Please let us know if there is any medicine which can cure this problem also any alternative way to surgery. Hope to hear positive reply soon from you end. You may contact us on +91 0000 and +91 0000. With regards, Anjali Misal Mumbai
Asked On : Fri, 22 Feb 2013
Answers:  1 Views:  181
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  User's Response

You mention the your sister has symptoms of back pain. The ultrasonogram has shown that the right kidney is grossly enlarged (normal 9-11cm, but 16cm in her case). The DTPA renogram shows an obstructed drainage.

In a symptomatic patient it is always better to go for surgical treatment. Unfortumately there is no medical treatment for this condition. It can be explained in a simple mechanical example where in the out flow pipeline is blocked and there is enlarged kidney as a result of the pressure built up.

If you can remove the blocade then it will help at this stage especially because the relative function of the kidney despite being hydronephrotic is still at 34% which is good. You can preserve the kidney function if the surgery is done at this stage.

You can consider a laparoscopic surgery if you are not interested in an open procedure. This will have good results and less scarring.

Hope it was helpful.

Answered: Fri, 22 Feb 2013
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