<s>[INST] Good morning Dr.    I want to know the further treatment and advise and seriousness of the below  report  Right kidney measures 11cms.  Right kidney show normal echopattern with noevidence of calculi or calyceal dilation  Left kidney measures 10 cms an shows increased cortical echoes.  CMD is slightly decreased  Prostate measures 4 x 3 x 3 cms and shows normal echopattern.  Bladder is normal in contour.  Both iliac fossae appear normal  Diabetic  Glucose serum/plasma (Fasting)  291  (Post Prandial)  488     Age  57 years [/INST] Hi... I'm dr. Charles... based on your blood glucose level... it suggests day u r a diabetic in d first place... secondly your right kidney is normal... but in your left kidney... its shows a few small cysts in d cortex and cmd being decreased... wat is cmd... it is cortico medullary differentiation... it isnd differentiation of the putter portion of the kidney called cortex and the inner portion called medulla due to specific cellular and tiasue structures. This cmd decreases in medical conditions like diabetes n hypertension. So this causes tissue changes wit reduced renal functions. So wat do we do next. U should first of all get your sugars under control. N secondly a blood test for serum urea and creatinine should be done to assess the kidney function. And a urine routine should also be done.These tests r done to rule out diabetic nephropathy. After dat u can go and visit a urologist for further management.. but ur sugars should b controlled. Hope this info was helpful for you. </s>