Background: Post Obstructive Diuresis (POD) is defined as urine output 200 ml/hour for two consecutive hours immediately subsequent to the relief of urinary tract obstruction. POD occurs in 0,5% to 52% of patients after the relief obstruction. It is usually self-limited, but If the POD becomes pathologic, it can cause serious consequences. We report a case of woman who had POD after underwent ureteroscopic lithotripsy procedure due to unilateral ureteral stone. Case Presentation: A 35-year-old woman came to ER with episodic left flank pain and LUTS. On examination, left costovertebral angle (CVA) tenderness was positive. An Abdominal X-Ray confirmed left distal ureteral stone. The patient was scheduled to have ureteroscopic lithotripsy procedure. After underwent the procedure, the patient drained 3500 ml of urine over 24 hours and showed clinical deterioration. The patients was diagnosed with acute kidney injury secondary to obstructive uropathy with serum creatinine 2.5 mg/dl. The patients urine output is 3150-4100 cc per day. Resuscitation with normal saline and moderate hypokalemia correction with potassium chloride infusion is initiated. Close monitoring of fluid balance, urine output, and electrolytes was done on our patients. A negative fluid balance with normal saline infusion should be limited to no more than 75% of 2-hour urine production to avoid diuresis stimulation. Conclusion: The prolonged course of polyuria in our patient may be a reflection of the chronicity of her obstruction. Patients at high risk for POD should be detected and monitored properly. Early diagnosis and appropriate management of POD will reduce mortality

Post-Obstructive Diuresis

Obstructive Uropathy

Fluid and Electrolyte Correction