Anuria is defined as less than 50cc of urine output in 24 hours. Obstruction to the flow of urine on both the sides and obstructive uropathy in a solitary kidney can lead to this condition. Complete absence of one kidney occurs more frequently than bilateral renal agenesis but is not easily detected from findings on physical examination. Unilateral renal agenesis may remain undetected unless examination of the external genitalia and/or radiographic evaluation of the female or male pelvis for other reasons reveal an anomaly associated with renal agenesis. As in this case, the entity came to light only when the patient presented to us with anuria due to pelvi-ureteric junction obstruction (PUJO) with renal calculi. It was only after he had recurrent anuria following D-J stent removal that an on table retro-grade pyelography was able to establish the PUJO. Such cases need to be regularly followed-up to monitor for any signs of renal failure. PUJO presenting as recurrent anuria per se is an uncommon mode of presentation.
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