Compensatory Hypertrophy in Kidney Function: What It Means

Q: Compensatory Hypertrophy in Kidney Function: What It Means

Hello Mr. <br>A Shui： First, I would like to confirm your kidney sizes, "one is 12 cm and the other is 9 cm." Were these measurements obtained from an ultrasound examination? The following information is based on the ultrasound findings. <br>Normal kidney size is approximately 10

Renal compensatory mechanisms疑惑

Hello, doctor.
I would like to ask if the phenomenon of compensatory hypertrophy in one kidney indicates that the other kidney has completely lost its function in medical terms? Will the smaller kidney still have function? One kidney measures 12 cm and the other 9 cm.
Both blood and urine tests are normal, but the doctor is uncertain whether this is congenital or acquired.
I forgot to ask the doctor while reviewing my health check report, and I've been thinking a lot about it at home, which has caused me anxiety.
Thank you for clarifying this for me.

A Shui, 30~39 year old female. Ask Date: 2020/07/15

Dr. Huang Yaoxuan reply Internal Medicine

Hello Mr.
A Shui: First, I would like to confirm your kidney sizes, "one is 12 cm and the other is 9 cm." Were these measurements obtained from an ultrasound examination? The following information is based on the ultrasound findings.
Normal kidney size is approximately 10-12 cm, but the accuracy of ultrasound in measuring kidney size is not very high (ultrasound captures a two-dimensional image; scanning the kidney is akin to slicing an object.
If the slice is slightly off, it may appear smaller than its actual size).

Regarding the compensation you mentioned, you are correct; it refers to the phenomenon where one kidney enlarges after the other kidney loses function (or is removed).
The non-functioning kidney will have almost no function, and the size of the compensating kidney will depend on the duration of compensation, age, and other health conditions.
Since this is a natural adjustment by the body, it does not have further implications for health.
Typically, a non-functioning kidney will atrophy, potentially shrinking to 6-7 cm or smaller, while the compensating kidney can enlarge to 13-15 cm or even larger, with a size difference of up to twofold.

In ultrasound imaging, assessing the condition of the kidneys also requires attention to other factors (such as the echogenicity of the kidneys, the thickness of the renal parenchyma, and the presence of hydronephrosis).
Size is not the most critical aspect.
Finally, if needed, you can discuss this with your physician.
Thank you!

Reply Date: 2020/07/15

More Info

Compensatory hypertrophy in the kidneys refers to the phenomenon where one kidney enlarges and increases its functional capacity to compensate for the loss of function in the other kidney. This can occur due to various reasons, including congenital abnormalities, surgical removal of a kidney, or damage to one kidney from disease or injury.
In your case, the presence of compensatory hypertrophy, where one kidney measures 12 cm and the other 9 cm, does not necessarily indicate that the smaller kidney has no function at all. It is possible for the smaller kidney to still have some degree of function, albeit reduced compared to the larger kidney. The fact that your blood and urine tests are normal suggests that your overall kidney function is adequate, and the larger kidney is likely compensating effectively for any loss of function from the smaller one.

The kidneys are remarkable organs that can adapt to changes in their environment. When one kidney is damaged or removed, the remaining kidney can undergo hypertrophy, which means it increases in size and function to handle the body's needs. This compensatory mechanism can be quite effective, allowing individuals to live healthy lives with only one functioning kidney or with one kidney that is less functional than the other.

However, it is essential to monitor kidney function over time, especially if there are concerns about the smaller kidney's health. Regular follow-up with your healthcare provider, including blood tests to check creatinine levels and urine tests to assess for protein or other abnormalities, is crucial. These tests can help determine if the smaller kidney is maintaining any function and whether there are any signs of deterioration.

Regarding your anxiety about the situation, it is understandable to feel concerned when faced with health uncertainties. It may be helpful to discuss your worries with your healthcare provider during your next appointment. They can provide reassurance, clarify any uncertainties, and help you understand the implications of your kidney function and structure. Additionally, engaging in healthy lifestyle choices, such as maintaining a balanced diet, staying hydrated, and exercising regularly, can support overall kidney health.

In summary, compensatory hypertrophy does not automatically mean that the smaller kidney is non-functional. It may still have some degree of function, and your normal blood and urine tests indicate that your overall kidney function is currently stable. Regular monitoring and open communication with your healthcare provider will be key in managing your health and alleviating your concerns.

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