Staghorn renal stone in a transplanted kidney

Calculus formation in the renal transplanted patient is uncommon and usually represents a late complication of secondary hyperparathyroidism. A case report of a gouty patient with a transplanted cadaveric kidney is presented. The patient presented without hypercalcemia, or urinary infection, or renal tubular acidosis, or ureteral obstruction, or ingestion of antacids, or metabolic disease, or previous graft lithiasis. Five months after transplantation, a large stone within the renal pelvis was observed on an x-ray film. The radiotransparent nucleus, the patient's past history and the acute gouty arthritis he presented in the immediate postoperative period suggested that the nucleus of the calculus might be mainly composed of uric acid. These facts have drawn our attention to the control of the purine metabolism in the renal transplanted patients who have a past history consistent with gout.