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Forum Name: Miscellaneous Nephrology Topics

Question: thinning parenchyma, increased resistive indices, small kidn


 worriedmomhere - Wed Aug 03, 2005 7:04 am

After having problems with my gall bladder, it was discovered through a renal ultrasound that my kidneys are small (108 mm), diminished parenchyma bilaterally, and resistive indices are somewhat high (.67 on left and .73 on right).
I saw a nephrologist who was very nice, but I didn't get much info from. I guess I was in shock when they said that I had chronic renal insuff that I couldn't ask any questions.

Can someone PLEASE tell me what these test results may mean? She said that I had chronic renal insuff., but didn't tell me much after that. I've got 3 children and I'm in my mid thirties.

It's been almost a year since I met with the neph., and I've noticed a couple of things that she said to watch out for. On just a few occasions I've had high BP and swelling in my feet and hands.

Thanks so much in advance for any ideas that you could give me.
 Janice H, LPN - Sun Aug 07, 2005 10:15 pm

The issues you describe are things you should sit down and discuss with your Dr. , especially if this information is a year old. Because you have noticed your BP to be elevated at times and you are possibly retaining fluid in your hands and ankles, you should be seen. You may want to meet with your Primary first, since you should always keep them in the loop with your overall care. You should make another appointment with your nephrologist and let them know you specifically want time to discuss the information given to you. It is quite possible you will be scheduled for tests again to do a comparison with last years findings. Make sure you write down all your questions before you go so you don't forget any of them. Your primary may also be able to help you with your questions. To answer some of them here, resistive indices are assigned to your kidneys through ultrasound. There are "normal" ranges which are frequently associated with .70 or less. Higher can mean obstructions. But these numbers can vary with each patient which is why you should discuss it with your nephrologist. Ask him/her what changes may occur over the next few years and what you can expect. Chronic Renal Insufficiency means that your kidneys are not functioning to their normal filtering capacity and may decrease in time. (the amount of time can be many years) Again, this is something you want to monitor and discuss with your Dr how frequently you should be seen - yearly, twice a year, ect. Best wishes.

nys1emt
 worriedmomhere - Tue Aug 09, 2005 8:20 am

Thank you nys1emt - I really appreciate your response to my post!

After speaking with both my PCP and neph., they both want to see me. I have an appt with my PCP on Friday (8/12), and with my neph. in mid Sept.

I will make a list of my questions, and hopefully I can ease my mind a little. Mt neph. is very nice, but I guess because last time I didn't ask questions, didn't get a lot of info. I'll be sure to be specific in my questions, and I'm sure she'll give me good info.

Thanks again!
 worriedmomhere - Tue Aug 09, 2005 1:06 pm

I forgot to ask - do you know what diminished parenchyma bilaterally means?

Thank you for any help you could offer.
 worriedmomhere - Fri Aug 12, 2005 9:12 pm

I had my appt with my primary today. They took my BP twice - first time it was 142/77 & second time was 137/69. She said it was a little high, especially for someone with kidney disease. I didn't have any swelling in my hands or feet today, so that wasn't an issue today.

She ordered lots of blood work, and just said basically that I need to wait until I can see my nephrologist on Sept 20 to see what she has to say.

So, it seemed like a bit of a waste of time and $25 co-pay to be told that my BP is a little high, since I already knew that.
 Janice H, LPN - Tue Aug 23, 2005 8:58 pm

Hi worried mom here - sorry it took a few days to answer; my connection was down..

Diminished parenchyma bilaterally - parenchyma refers to the functional part of an organ - thus diminished means functioning less than it should - bilaterally means both sides.
I know you are probably feeling discouraged having gone to your primary and feeling like you didn't need to go and wasted your money - BUT - here's the deal why it is important to go...when you go to the nephrologist, usually one of the first things they want to know is if you have been seen by your primary recently. Your nephrologist CANNOT be responsible for your standard care and medications. If you had required BP meds, or any other meds for that matter (cholesterol meds, arthritis meds, ect), only your primary is usually responsible to prescibe these things. These are things the nephrologist needs to know in case they have to prescibe meds as well to make sure they do not give you anything that will interact with what you are already taking. Any tests you had, you should request that your primary fax copies to the nephrologist and also the ones you have from them should be copied to your primary. This way they are both involved in your care and you get the best of both worlds.

nys1emt
 worriedmomhere - Wed Sep 07, 2005 7:48 am

Thanks for your reply nys1emt!

My primary did not want to do anything until I saw the neph - I think because they are the specialist (besides the fact that my pcP had taken allergy meds and they had REALLY knocked her out and she had a hard time staying awake...LOL!). My appt with my neph is less than 2 weeks away, so I'm hoping for some answers!

Again, thanks for replying to pmy post and giving all the great info. It's nice to have an expert's point of view!

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