Is Kidney Shrinkage Serious? Ultrasound Results and Function

Is it serious if an ultrasound examination suggests that the kidneys are possibly smaller?

Hello, doctor.
I recently had a routine kidney check-up (due to having hematuria since childhood and regular follow-ups).
My kidney function is otherwise normal, except for a creatinine level of 0.42 mg/dL and trace hematuria.
However, the report indicated that my left kidney measures 9.08 cm and my right kidney measures 9.38 cm, which seems smaller than the previous measurement of 9.9 cm and also smaller than normal.
My height is 158 cm and I weigh 47 kg.
Could this indicate that the kidneys are atrophying and that it might affect kidney function? Or am I just worrying too much and this could be a measurement error? I'm a bit concerned, thank you for your clarification! Wishing you all the best!

Bella, 30~39 year old female. Ask Date: 2012/03/24

Dr. Wu Jiyu reply Internal Medicine

The size of the kidneys is not necessarily related to kidney function; it is important to look at the results of blood tests and urinalysis for accurate assessment.
Additionally, in terms of size, while 9 cm is smaller than 10 cm, the difference is minimal and does not warrant excessive concern.

Reply Date: 2012/03/24

More Info

Kidney shrinkage, or renal atrophy, can be a concerning finding on ultrasound, especially in the context of your medical history of hematuria (blood in urine) and regular monitoring. The measurements you provided indicate that both your left and right kidneys are smaller than the typical size range for adults. Normal kidney size can vary, but generally, adult kidneys measure approximately 10 to 12 cm in length. A decrease in kidney size can suggest a variety of underlying issues, including chronic kidney disease, renal scarring, or other forms of renal pathology.

When interpreting ultrasound results, it is essential to consider the context of your overall kidney function. In your case, you mentioned that your creatinine level is 0.42 mg/dL, which is quite low and suggests that your kidneys are still functioning well in terms of filtering waste from the blood. However, the presence of hematuria and the noted shrinkage of the kidneys warrant further investigation.
Kidney shrinkage can occur due to several reasons:
1. Chronic Kidney Disease (CKD): This is a progressive loss of kidney function over time. If the kidneys have been damaged due to conditions such as hypertension, diabetes, or glomerulonephritis, they may shrink as they lose functional tissue.

2. Renal Scarring: Previous infections or injuries can lead to scarring of the kidney tissue, which may result in a reduction in size.

3. Vascular Issues: Conditions affecting blood flow to the kidneys can also lead to atrophy.

4. Congenital Anomalies: Some individuals may have naturally smaller kidneys due to developmental issues.

Regarding your concern about whether this shrinkage could impact kidney function, it is possible. If the shrinkage is due to chronic damage, it could lead to a decline in function over time. However, if the kidneys are still functioning well, as indicated by your low creatinine levels, it may not be an immediate concern.
Measurement discrepancies can occur due to various factors, including the technique used during the ultrasound, the patient's position, and even the equipment itself. It is always a good idea to discuss these findings with your healthcare provider, who can assess whether a repeat ultrasound or additional tests, such as blood tests or a CT scan, are necessary to monitor your kidney health more closely.

In terms of management, if kidney shrinkage is confirmed and linked to a specific condition, your doctor may recommend lifestyle changes, medication, or regular monitoring to prevent further deterioration. Maintaining a healthy diet, controlling blood pressure, and avoiding nephrotoxic substances (like certain medications) are crucial steps in preserving kidney function.

In conclusion, while kidney shrinkage can be serious, it is essential to evaluate it in the context of your overall kidney function and health history. Regular follow-ups and open communication with your healthcare provider will help ensure that any potential issues are addressed promptly. If you have further concerns or experience any new symptoms, do not hesitate to seek medical advice.

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