A 46-year-old woman presented to the emergency department with a 2-day history of right-sided loin pain and macroscopic hematuria. The pain was continuous and dull in character. Over the past ten years, she had previous episodes of loin pain that have occurred on both sides and resolved spontaneously over a few days. She had never passed any stones. She was noted to be mildly hypertensive during her three pregnancies. She had no other significant medical history. The woman worked as a teacher and neither smokes nor drinks alcohol.
Family history: The woman's father died of a subarachnoid hemorrhage at 48 years of age. Her father’s brother had a kidney transplant. She has no siblings. Examination Temperature: Afebrile Pulse: 76/min Blood Pressure: 135/105 mmHg. Examination of the cardiovascular and respiratory systems is otherwise unremarkable. Ballotable masses were palpable in each…
