Reflex anuria and uremia from unilateral ureteral obstruction

A 59-year-old man had anuria of 32 hours' duration that was associated with unilateral calculous ureteral obstruction. Retrograde pyelography showed a normal contralateral collecting system. Initial technetium pentetate (DTPA) scanning showed diminished uptake of radioactivity by the unobstructed kidney compared with the obstructed kidney, whereas a follow-up study, after relief of ureteral obstruction, showed a reversal of this pattern. Previously reported cases of "reflex anuria" are reviewed along with the relevant experimental literature. Vascular or ureteral spasm related in part to abnormality of the autonomic nervous system may underlie this rare entity.