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August 18, 1978

Dissolution of Bilateral Uric Acid Calculi Causing Anuria

Author Affiliations

From the Division of Urology, University of California School of Medicine, San Francisco.

JAMA. 1978;240(7):670-671. doi:10.1001/jama.1978.03290070072023

THE NONSURGICAL therapeutic approach to anuria caused by obstructive uric acid calculi has been advocated for poor-risk patients.1 We recently used this method of treatment for a similar problem, which was successfully resolved by administration of allopurinol, alkalinization of the urine, and catheter irrigation of the renal pelvis with sodium bicarbonate solution.

Report of a Case  A 42-year-old man with left flank pain, nausea, vomiting, and hematuria was examined in the emergency ward. Excretory urography disclosed a questionable filling defect in the right renal pelvis and delayed function on the left side. At three hours into the pyelographic study, the left flank pain suddenly disappeared, and a film showed mild caliectasis and contrast medium now passing through an undilated left ureter. The patient was asymptomatic when discharged, but came back six days later, again complaining of flank pain with intractable nausea and vomiting.He indicated no previous history of