### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am 43 y/o female, diagnosed with ESRD. On December 2013, I had renal ultrasound in the Philippines which suggested that I have normal right side kidney and slightly enlarged left kidney with parenchymal cyst on both kidneys. I am in the US now and did renal ultrasound this month and my neprhrologist said I have kidney atrophy. I already started dialysis on March 2014 in the Philippines with initial creatinine level of 6.9 and potassium level elevated at 7.8. I am not diabetic and not hypertensive. I weight 122 lbs, 5ft 1inch tall. No swelling. Still making urine. I am continuing dialysis here and all my lab works are normal except for my phosphorous and PTH which are both elevated. My brief history. I use to be hypokalemic ( I reached as low as potassium level 1.2!),I was hypertensive and was on hypertensive medication since I was 21 y/o. I used to be obese (175 lbs) during those times and had bad diet. Today, I am no longer on hypertensive medication. Only on Phosphate binder Sevelamer, and Sensipar and dialebyte vitamin. I am compliant to renal diet now.

### output:

Hello and welcome to Chat Doctor. As a Urologist, I can fully understand your concern.It's essential for you to be on hemodialysis, due to ESD. The recent U/S scan showed kidney atrophy, which suggests, reduced kidney size. The reports mentioned by you are seen in ESD.You've been on treatment for bilateral renal polycystic disease(AP CKD), with hypertension, since past 22 years. This has lead to ESD. Maintain the renal diet as advised, and check creatinine and electrolytes, regularly. You may have been told about kidney transplant as an option to dialysis. You can send me a direct question, if you have any doubt. Chat Doctor.  Manga.