<p>The liver is normal in size and parenchymal echogenicity. No focal hepatic mass lesion is seen. The intrahepatic biliary channels and CBD are not dilated.&nbsp;</p><p>The gallbladder is moderately distended with clear bile and shows normal mucosal wall thickness. No calculus is seen within it. The kidneys are normal in positions, shapes, sizes and outlines. They measure 93 and 97mm in their respective bipolar length on the right and left sides. They show increased in their parenchymal echogenicity greater than that of the Liver and spleen on the right and left sides with loss of corticomedullary differentiation. No definite focal renal mass lesion or hydronephrosis is seen.</p><p>The kidneys are shrunken in sizes. However, they are normal in positions, shapes and outlines. They measure 76mm each in their respective bipolar length on the right and left sides. They show increased in their parenchymal echogenicity greater than that of the Liver and spleen on the right and left sides with loss of corticomedullary differentiation. No definite focal renal mass lesion or hydronephrosis is seen.</p><p>The spleen, pancreatic bed and paraaortic area are within normal limits.</p><p>The visualized bowel loops shows normal caliber, outline and peristaltic activity. No bowel mass lesion is seen. No ascites is demonstrated.&nbsp;</p><p>The uterus is normal in size and empty. It measures 25mm in it is widest AP diameter. It shows uniform myometrial and endometrial echos. It shows no definite focal myometrial or endometrial mass lesion seen. Both adnexae are free.&nbsp;</p><p><strong>Conclusion – Bilateral grade IV renal parenchymal disease</strong></p>