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Suggest Treatment For Enlarged Kidneys In An Infant

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Posted on Fri, 12 Jun 2015
Question: Hydronephrosis and parenchymal thickness seen in my 3months old baby. the size of the left kidney is enlarged in size from the scan seen in 1st week of his birth. Please advice the procedure what would be done in such cases.
Right kidney measures 4.8cm in length, parenchymal thickness 10mm
Left kidney measures 7.3cm in length, parenchymal thickness 5mm
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Answered by Dr. Diptanshu Das (12 minutes later)
Brief Answer:
There seems to be an obstruction which needs to be removed.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through the details provided. It seems that there is an obstruction somewhere in the renal tract. It so happens that if there is an obstruction, the urine gets retained and thus creating a backpressure. This pressure leads to the swelling of the ureters and the kidney canals, the conditions what we refer to as hydroureter and hydronephrosis. The kidney is trying to comepensate but the backpressure would cause damage to the kidney parenchyma or the functional area of the kidney, thus causing decrease in the parenchymal thickness. The condition is likely to worsen unless the cause of obstruction is removed. Posterior urethral valve (PUV) is the simplest form of obstruction but an assumption cannot be taken in this regard. I would suggest you to consult a pediatric nephrologist/urologist and discuss about undertaking a DMSA scan ( isotope scan ) for further evaluation of the same. Depending upon the findings, surgical intervention might be required.

Regards
Dr. Diptanshu Das
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3875 Questions

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Suggest Treatment For Enlarged Kidneys In An Infant

Brief Answer: There seems to be an obstruction which needs to be removed. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone carefully through the details provided. It seems that there is an obstruction somewhere in the renal tract. It so happens that if there is an obstruction, the urine gets retained and thus creating a backpressure. This pressure leads to the swelling of the ureters and the kidney canals, the conditions what we refer to as hydroureter and hydronephrosis. The kidney is trying to comepensate but the backpressure would cause damage to the kidney parenchyma or the functional area of the kidney, thus causing decrease in the parenchymal thickness. The condition is likely to worsen unless the cause of obstruction is removed. Posterior urethral valve (PUV) is the simplest form of obstruction but an assumption cannot be taken in this regard. I would suggest you to consult a pediatric nephrologist/urologist and discuss about undertaking a DMSA scan ( isotope scan ) for further evaluation of the same. Depending upon the findings, surgical intervention might be required. Regards Dr. Diptanshu Das