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Can the two kidneys be of different size in children?

Q: My 4 years old son has a difference in the kidney size of more than 1.3 cm. The left kidney is 65x27 mm while the right one is 78x33 cm. He does not have high blood pressure. Is this a cause of concern? The doctor says that normally the difference should be 0.8 cm. Is there any problem? His brother (6 months old) has been detected with Grade III urinary reflux and is currently on medication. The ultrasound reports says that the kidney size is fine. What do we do?

A:In a full-term new born baby, the kidney usually measures 5-6 centimetres in length and in an adult, it measures 10-12 centimetres. It is noted that there could be >5% variation in kidney ultrasound measurements obtained in the same child by different observers though this will not account for a significant difference in both the kidney sizes in the same child. The size of both the kidneys in your son is within the normal range for his age. As long as your son’s kidney function are normal (which would be obvious from a series of blood tests and renal imaging studies), there should not be any concern neither for the difference between both the kidney sizes nor for future kidney function impairment.

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