Hi, Thanks for query, You have not mention about corticomedullary difference ?is this maintained. Due to kidney diseases the kidney shows enlargement in size but cortex & medula both enlarged or only single one is an important aspect. A general rule is that small kidneys depict chronic renal disease and enlarged or at least normal sized kidneys depict acute and therefore potentially reversible disease. A further distinguishing feature is parenchymal echogenicity. Diseased kidneys in general show increased echogenicity, however in the early stages echogenicity may still be normal. Increasing echogenicity is directly correlated to histopathological abnormality. acute obstructive disease ,acute pyelonephritis or renal failure may be the possibility. The S.creatinine level is a better tool to measure kidney function. Thanks.