End-stage renal disease with giant bladder calculus

tonitis. The laboratory findings were haemoglobin 9.6 g/dL, haematocrit 29%, serum urea 228 mg/dL, creatinine 7.6 mg/dL, sodium 135 mEq/L, chloride 110 mEg/L, potassium 7.1 mEq/L, albumin 2.4 g/dL, arterial pH 7.29, pCO2 15.7 mmHg, HCO3 7.5 mEq/L and BE −16.0. The abdominal X-ray showed an elliptical radiopaque mass∼7 cm in its highest diameter in the bladder region (Figure 1). Daily dialysis was performed owing to hyperkalaemia and uraemic symptoms. Laparotomy was performed and it revealed a perforation of the bladder wall, a vesical diverticuli and a giant calculus. The urinary cultures were negative. Laboratory analysis showed that the calculus (Figure 2) was made of calcium and oxalate (>80%), uric acid and ammonia. The patient was diagnosed as having a posterior urethral valve and had developed end-stage renal disease. Dialysis therapy has continued for 2 years, and the patient is awaiting renal transplantation.