Irreversible acute renal failure after bilateral extracorporeal shock wave lithotripsy.

A 75 year-old man underwent double extracorporeal shock wave lithotripsy (ESWL) for bilateral nephrolithiasis. After the first treatment, serum creatinine rose to 247.52 mcmol/L. After the second treatment the patient presented persistent gross hematuria and, a few weeks later, oliguric renal failure; serum creatinine rose to 884 mcmol/L. Diagnostic evaluation with ultrasound revealed no obstructive complications, and no subcapsular or perirenal hematoma. The patient started chronic hemodialysis.