<human>: My 22 month old boy had his first UTI at 3 months old and was diagnosed with left kidney grade 4 and right kidney grade 2 vesicoureteric reflux. He has been on long term bactrim ever since. No more UTIs have been diagnosed. His latest ultrasound showed: left kidney diminutive size (no growth since 3months old) length 4.2cm. Significant scarring of parenchyma in interpolar region, reduction of parenchyma to 3mm. Right kidney generalised increased echogenicity, good preservation of parenchyma 6.1cm length. What would you suggest for ongoing treatment, diagnostic tests for function required cystatin c, creative etc and surgical intervention.
<bot>: Good day! I would suggest doing a DMS scan to determine kidney function and to check for scarring and how much of the kidneys are still functioning. These tests would help you decide whether surgery for reflux will be indicated. If there is evidence of progression of scarring I think it will be in the best interest of your child to have the surgery to salvage his left kidney function. Best of Luck and Thank you.