Abstract

A 56-year-old woman with diabetes mellitus and kidney failure treated by kidney transplantation 3 months prior is referred to your clinic for elevated serum creatinine. She gives a personal history of recurrent urinary tract infections in the setting of obstructive uropathy and recurrent nephrolithiasis. Two years ago, she developed kidney failure. Imaging at the time revealed staghorn calculi with left hydroureter (Fig 1). She underwent bilateral ureteral stent placement with some improvement in glomerular filtration rate (GFR); however, she continued to experience progressive GFR decline and required hemodialysis.

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