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Renal parenchymal disease basically appear echogenic. There are three grades of renal parenchymal disease.

Grade 1: the Kidney parenchyma is isoechoic to the liver, but there is still cortiomedullary differentiation.

Grade 2: the kidney parenchyma is hyperechoic to the liver with preservation of corticomedullary differentiation.

Grade 3: kidney appears hyperechoic. No corticomedullary differentiation!

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