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Is having one congenital kidney larger than the other a disease?

Feb 24, 2025 Source: Cainiu Health
Dr. Yang Guang
Introduction
In general, when one kidney is larger than the other, it refers to renal volume asymmetry. Whether renal volume asymmetry constitutes a disease depends on the specific circumstances. If the size difference falls within the normal range and there are no abnormalities in the kidneys, it typically is not considered a disease. However, if the size difference exceeds the normal range or if abnormalities in kidney structure or function are present, it may indicate a disease.

Generally, when one kidney is larger than the other at birth, it refers to kidney size asymmetry. Whether kidney size asymmetry constitutes a disease needs to be determined based on specific circumstances.

If the size difference falls within the normal range and no kidney abnormalities are present, it typically is not considered a disease. However, if the size difference exceeds the normal range or structural or functional abnormalities of the kidneys occur, it may indicate a disease. If concerns arise, timely medical consultation and relevant examinations are recommended. Detailed analysis is as follows:

Under normal circumstances, the two kidneys in the human body are not exactly the same size; a certain degree of physiological variation is common. Usually, this variation is manifested in imaging studies as a size difference between the two kidneys of no more than 1–2 cm. If one kidney is larger than the other at birth, but the difference falls within this physiological range, and no abnormalities are detected through urine, blood, or imaging tests, this is usually due to incomplete development of one kidney, resulting in compensatory enlargement of the opposite kidney. In such cases, the kidney size difference remains within the normal range and generally does not cause significant health problems, thus it is not considered a disease.

If the size difference between the two kidneys exceeds the normal range or structural or functional abnormalities are present, it may indicate an underlying disease. This situation could be caused by conditions such as congenital developmental abnormalities, renal artery stenosis, atherosclerosis, or unilateral renal tuberculosis, which lead to shrinkage of one kidney, and therefore is considered pathological. Treatment should target the underlying disease to restore normal kidney function.

It is recommended that individuals maintain healthy lifestyle habits in daily life, such as regular physical activity and balanced nutrition, to help promote kidney health.

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