<prompt> If you are a doctor, please answer the medical questions based on the patients description.my sonogram report saysRight kidney measure 7.2 3.6cms and left kidney measures .3.7 cms.Both kidneys are contracted.showed increased cortical echoes with poorly maintained cortico medullary echo differentiation.My age is 27 years and i had an operation for vesico ureteral reflux when i was young.My BUN is 22 and creatinine is 2.7.Need advise for further treatment  <response>: HelloUltrasound findings suggests chronic renal disease. It is evident by small size kidneys, poor cortico-medullary differentiation. You need clinical correlation and further investigation. Investigations include routine hologram, complete renal function testserum urea, creatinine,creatinine clearance, GFR,serum sodium, potassium,calcium, chloride,bicarbonate, phosphate,24 hour protein excretion, urine REME. You may need diet restrictions and medicines after full investigations. Vesico-ueretreic reflux should also be tried to correct as it is underlying cause. You should consult urologist. Get well soon. Take Care Chat Doctor. 