A 65-year-old man with untreated gout presented with a 1-month history of asthenia, anorexia, weight loss, and progressive weakness. Physical examination revealed hypertension (145/94 mm Hg) without peripheral edema. Laboratory investigations demonstrated severe acute kidney injury (serum creatinine 13.95 mg/dL, blood urea nitrogen 371 mg/dL), requiring hemodialysis. Computed tomography (CT) of the abdomen revealed bilateral hydronephrosis associated with staghorn calculi and multiple bladder stones, with a CT attenuation value of