What is a 10x6x9mm echogenic focus in the upper pole of the right kidney with a faint posterior shadow with twinkle artifact and what should i do next?

Ultrasound findings: Something in the kidney is causing abnormal ultrasound echoes to be picked up on the scanner. It's possibly a stone. However, this is just a finding. You (or rather your doctor) should correlate this with SYMPTOMS. Whatever this "focus" is, it may not be relevant- talk to the doctor who ordered the ultrasound for a medical opinion.