Hello Thanks for writing to HCM Bilateral raised cortical echogenicity with contracted right kidney indicates renal parenchymal disease.It may be due to many reasons like hypertension,Diabetes mellitus,autoimmune diseases etc. Serum creatinine level is also increased. He need proper clinical examination and further investigations. Investigations include routine hemogram,RBS,LFT,RFT(includes serum urea,creatinine clearance,GFR,serum electrolytes like sodium,potassium,calcium,phosphorus,chloride,bicarbonate etc). Proper treatment depend upon clinical findings and investigation reports. Hope i have answered your query. Take Care Dr.Indu Bhushan