High cortical echo in both kidneys is not necessarily renal fibrosis. Normal renal cortex should be hypoechoic, and high cortical echo in both kidneys may be inflammatory changes in the kidneys, or there may be chronic renal parenchymal damage, chronic fibrosis and so on. 1. Inflammatory changes: the kidneys have inflammatory changes, inflammatory changes mean that the kidneys are edematous, which may be manifested as increased echogenicity on renal ultrasound in some cases. 2. Chronic renal parenchymal damage: High cortical echogenicity in both kidneys may also indicate chronic renal parenchymal damage, such as chronic nephritis or nephropathy. 3. Chronic fibrosis: High cortical echogenicity of both kidneys may also indicate chronic fibrosis of the kidneys, and many diseases can lead to increased cortical echogenicity of both kidneys. If ultrasound suggests bilateral renal cortical echogenicity. If there is a high cortical echo in both kidneys, it is recommended to go to the hospital in time, further improve the urine and blood tests, and carry out targeted treatment under the guidance of the doctor.