Nephrolithiasis is a rare finding in kidney transplantation and anuria could be the only clinical sign. We report the case of a 52-year-old Caucasian male renal transplant recipient admitted due to acute renal failure (ARF) and anuria. He reported no symptoms and a palpable bulge in the right iliac fossa corresponding to the graft was present. Ultrasonography showed hydronephrosis of the graft. A double-J ureteral stent was inserted with resolution of ARF. ARF with anuria and the presence of a palpable non-tender, elastic mass over the graft could be the clinical picture of obstructive ARF in a transplanted kidney.
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