Bilateral stones as a cause of acute renal failure in the emergency department

Acute renal failure (ARF) due to obstructive uropathy is a urological emergency. The standard radiological investigations in the emergency setting include X-ray, ultrasonography and computed tomography. But occasionally the cause of obstruction may be elusive. We present a case of obstructive uropathy due to bilateral stones presenting as acute renal failure. The patient underwent successful shock wave lithotripsy (SWL) for dissolution of calculi. The patient was successfully treated, and reported asymptomatic in a follow-up. Close collaboration between nephrological, urological, and radiological services is required.