Hi thanks for asking question. Serum creatinine is usually below 1.Here it is 22 , means there has been significant damage has occured to kidney. Here kidney condition should be evaluated , and status of second kidney also evaluated. You can have shrunken kidney might be because of long term diabetic nephropathy, chronic glomerulonephritis or long term nephrosclerosis. Measure your blood pressure and estimate your blood glucose level. Here as further work up ,apart from usg, kidney biopsy also has to be taken for proper diagnosis and treated accordingly. so, better first to clear cause of shrunken kidney by investing and then go for surgery. I hope my suggestion will you.