Hi, Thanks for writing in. I guess you have got ultrasound scan done and the report findings are mentioned by you. The details in simple language are below. 1. Small kidneys with diffuse increased echogenicity of renal parenchyma billaterally and loss of corticomedullary differentiation. Likely related to chronic medical renal disease. This means that the kidneys have slightly shrunken in size and the appearance of the renal cortex is increased. In other words, the kidneys have started to function below normal and this might be related to conditions like diabetes or high blood pressure should you be having either or both of them. 2. Mild to moderate left pelvicalyceal dilatation with mild thickening of urothelium. The left kidney shows a suspected block in the collecting system and also the thickening of the lining of tubes connecting the kidney to the bladder on the left side. The above findings are indicative of a decreasing kidney function. This needs to be reviewed by a nephrologist and they might suggest further testing to know the quantitative functioning of kidneys by doing tests like creatinine clearance and radioisotope renal function. Treatment is based on controlling any other medical condition that you might have and delaying the progression of renal failure by giving medicines.