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Is atrophied kidney needs to be removed?

Q: My 28 years old cousin is diagnosed with USG. His right kidney measures 4.5 cm and left kidney is 11.5 cm. All other functions of kidney are normal on haemogram and urinary analysis. In duplex doppler small kidney is not visualised while the normal perfusion in other kidney is observed. Presently he does not have any complaint related to kidney or any other system, but the small kidney has also lost the corticomedullary junction.

  1. Is there any need of nephrectomy for small non-functional kidney?
  2. Can this atrophied kidney be retrieved?
  3. What are the complications may arise?

A:Your cousin may have been born with a dysplastic kidney or he may have had an infection called pyelonephritis, which can cause shrinkage of kidney. This kidney needs to be removed only if there is uncontrolled blood pressure resulting from this kidney or there is uncontrolled life threatening infection related to this kidney. One must also evaluate the function of this kidney before deciding to take it out. There are no medicines to recover lost kidney size and or function. The blood pressure should be monitored regularly and targeted at less than 130/80 mmHg to preserve the function of the other kidney.

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