Q: I am a 60 years old man diagnosed with a shrinking kidney. What are the possible causes and how can shrinking kidney be managed? Is this considered as kidney disease?

A:Advanced kidney disease due to most diseases (excepting polycystic kidney disease and few other rare causes) cause kidney size to diminish. The common diseases that do this are advanced diabetic kidney disease and advanced hypertensive / vascular kidney disease. In addition to thorough physical examination and urinary tests to see if there is any abnormal protein or blood in the urine, you have to undergo blood tests to estimate the level of kidney function and to find out the possible cause. If these tests are unrevealing, you might need kidney biopsy to identify the exact cause. However, if the kidney disease is too advanced with scar formation, kidney biopsy may not be revealing of any particular cause. If you are able to identify the cause of kidney disease and intervene early in the course, there is a chance of delaying the progressive worsening of kidney disease.