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What is the prognosis when there is loss of cortico-medullary differentiation?

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Posted on Wed, 21 Jul 2021
Question: Dear i have a kid 10 years and his ultrasound report was as follows :
U/S - URINARY TRACT: Findings: " Both kidneys increased in size measuring 11.5 x 6.5 cm with cortical thickness of 1.2 cm with loss of corticomedullary differentiation. Evidence of moderate-to-severe hydronephrotic changes. " Both ureters are seen significant dilated tortuous however, both ureters could represent changes of reflux. Voiding cystourethrogram is advised as the patient diagnosed "eagle XXXXXXX syndrome". " Urinary bladder dilated /enlarged with prevoid 1300 ml and post void 320 ml.

Is this early stage of renal failure? After the surgery for fixing the reflux / obstruction, kidney could be recovered to be normal? or effects on kidney parenchyma couldn't be retrieved?
" loss of corticomedullary differentiation " this is non-recoverable?
What is the treatment and next steps?
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Answered by Dr. Manuel C See IV (37 hours later)
Brief Answer:
Need GFR to determine function.

Detailed Answer:

Hi,

I am sorry to hear that your child is afflicted with prune belly syndrome. This syndrome as you may already know includes urinary system abnormalities that affects your child.

The reflux of the urine to the kidneys should be addressed as soon as possible and the reason for the reflux should be identified and corrected.

Kidney function could be salvaged/saved as long as corrected early. At this point In time I still wouldnt call it kidney failure.

Loss of corticomedullary differentiation means the kidney looks white on ultrasound and is because of swelling of the kidneys.

GFR is a better test to determine kidney function.

I suggest to see a pediatric urologist as Soon as possible.
Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Manuel C See IV

Urologist

Practicing since :2005

Answered : 909 Questions

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What is the prognosis when there is loss of cortico-medullary differentiation?

Brief Answer: Need GFR to determine function. Detailed Answer: Hi, I am sorry to hear that your child is afflicted with prune belly syndrome. This syndrome as you may already know includes urinary system abnormalities that affects your child. The reflux of the urine to the kidneys should be addressed as soon as possible and the reason for the reflux should be identified and corrected. Kidney function could be salvaged/saved as long as corrected early. At this point In time I still wouldnt call it kidney failure. Loss of corticomedullary differentiation means the kidney looks white on ultrasound and is because of swelling of the kidneys. GFR is a better test to determine kidney function. I suggest to see a pediatric urologist as Soon as possible.