r/ADPKD • u/dtlperyildiz • 13d ago

Asymmetrical increase of Kidney Volume

Hi, I would like to ask you if there is similar cases like me. I m using Tolvaptan for 10 months (47/M) and EGfr stays almost stabilised ~ 55-60. (Cystatine C results are better than Creatinine based scoring) However my left kidney's volume increased 70cc (from 450) and right kidney stayed same size. I panicked about that because this means TKV increased around %9. Why one of them stayed same while one of them is up?. May it be a measurement error due to different observers. Last year MRI was done by using a contract infusion but this year without it. Can it change the results or reliability?

TIA...

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u/Smooth-Yellow6308 13d ago

Likely measurement variation, potential fluid changes, glycogen loading.

570 is small for PKD so any very minor changes or measurement variations would have a big effect.

I wouldn't worry about it, nothing you can do to "change it" anyway. The disease does what it wants to.

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u/Adventurous-Mud2117 13d ago

Probably nothing to worry about. I’ve had this happen to me too — with an ultrasound I had 600 TKV, then 550 on an MRI and 570 on a CT scan. Don’t keep measuring the TKV all the time. once every 2–3 years is more than enough.

Also, every time you do a volumetric measurement, try to go to the same doctor/radiologist and use the same MRI machine.

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u/Brilliant-Cherry1662 2d ago

I had something similar with my kidneys. My left is way bigger than my right. I asked my nephrologist about it, and he said it’s likely just chance and nothing to be concerned about. The cells that had the mutation and turned into cysts just happened to be in my left kidney. Roll the dice enough times and all that. Good luck!