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Hyperdense kidneys

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

End stage renal disease.

Patient Data

Age: 25 years
Gender: Female
x-ray

On precontrast x-ray, both kidneys are small with hyperdense parenchyma and contain several stones in keeping with end stage renal disease.

Fluoroscopy

Voiding cystourethrogram demonstrates reflux into left kidney, with moderate dilatation of the left ureter and renal collecting system. The calyces are distended and blunted. 

Case Discussion

This case illustrates left sided grade 3 vesicoureteric reflux without duplex anatomy or posterior urethral valves. Both kidneys have relatively atrophic and hyperdense parenchyma due to long-standing end stage renal disease.

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