There is not a simple answer to your question. The long term effect of kidney dilation on one side depends upon the underlying problem causing the dilation, how quickly and severe the dilation is, and the long term health of the other kidney.
A multidisciplinary approach such as the one used at the UCSF Fetal Treatment Center (combining the expertise of radiologists, fetal surgeons, neonatologists, perinatologists, and other specialists such as pediatric urologists) can sometimes be helpful in situations where the evaluation and treatment course are not clear. If you are not near a center that offers such a service, consultation with a perinatologist and/or pediatric urologist can sometimes be helpful.
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