[Acute Oliguric Kidney Failure - Gut feeling versus Imaging]

We present the case of a 68-year-old patient with acute postrenal kidney failure, without evidence of hydronephrosis on repeated imaging. Diagnosis was complicated by a transient recovery of renal function and concomitant development of severe glomerular proteinuria. The decision to perform a bilateral nephrostomy despite the absence of hydronephrosis was based on the highly suggestive history of a postrenal kidney failure. Following the intervention, there was an immediate resumption of diuresis and complete recovery of the previously dialysis-dependent renal failure.