What can cause renal cortical scarring on both kidneys involving the upper poles? Everything else appeared normal on the US except that my right kidney was smaller than my left. Any other tests to determine the cause of the scarring? My creatinine and BUN levels are high.

Scarring is an non-specific response of the kidney to injury. Scarring can occur because of high blood pressure, infection, glomerulonephritis, trauma, drug induced injury, blockage of the ureter, blockage of the blood vessel and chemical injury. You can also be born with this abnormality. It is not specific for any particular disease. The right kidney is commonly larger than the left, so your right kidney may have suffered greater injury than your left. This is in contrast to diabetes, where the kidney tends to be enlarged with chronic kidney disease.
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