Q: My wife, aged 41, is suffering from kidney disease. The doctors wrote the following diagnosis: kidneys - small in size and irregular in contour and size of the right kidney: 88 x 24 mm, left kidney: 98 x 40 mm. The kidney size, after five months, has further reduced to right: 70 x 25 mm, left: 62 x 36 mm. Please advise.

A:Bilateral small sized kidneys (atrophy) are a sign of underlying chronic kidney disease (CKD) and are associated with the kidney’s irreversible, impaired filtering function. Atrophy of kidneys reflects loss of kidney parenchyma (organ body) and could be caused by a longstanding recurrent infection of the kidneys (reflux nephropathy), obstruction of the urinary tract, chronic intrinsic kidney disease and ischaemia (poor blood flow). It is usually rare to see a rapid atrophy of bilateral kidneys over a short period unless obstruction at the urinary tract level for a limited period leads to a backpressure induced rapid wasting of kidney parenchyma. While your wife would have undergone evaluation to assess the cause of her CKD, it would be helpful to know her serum creatinine value to exactly estimate her current kidney function. While it is not possible to retrieve the lost kidney function, it is however necessary to delay the progression of the kidney disease by focusing on the risk factors including strict control of blood pressure (goal of <130/80 mmHg) and avoidance of potential kidney toxic medications including common pain medicines like Voveran, Nimesulide and Brufen.