<s>[INST] both kidneys are normal in shape size and position. Renal parenchyma is more echo genic and normal. loss of corticomedullary differentiation noted in both kindeys . in blood report creatinine is 2.0 mg/dl.i am 35 years old . can you please tell me what does this mean? [/INST] HelloThanks for query. Kidney has two parts cortex and Medulla Cortex deals with the filtration of blood through kidney and production of urine along with excretion of waste products of protein metabolism (Urea and Creatinine)whereas medulla deals with blood flow to kidneys. In normal kidney during ultrasound scanning signal intensity of renal cortex is higher than that of medulla. This differentiation between signal intensity is reflected and well-defined in ultrasound very clearly. This differentiation is reduced in any renal parenchymal disease making it more echogenic than normal resulting into loss of differentiation between cortex and medulla. Since your Ultrasound report mentions cortex to be more echogenic and raised creatinine suggest that you have early Renal Parenchymal disease. Chat Doctor.  </s>