Abstract:[Abstract] Objective To explore the effective therapy for acute renal failure caused by upper urinary calculi, and to provide reference for the study on diagnosis and treatment of the future. Methods 67 cases of acute renal failure patients caused by upper urinary calculi from November 2013 to November 2014 in Affiliated Hospital of Hebei University of Engineering were selected, and they were divided into observation group (33 cases) adopted by percutaneous nephrolithotomy with holmium laser lithotripsy and control group (34 cases) took double positioning in vitro lithotripsy according to their order of treatment and individual will. Serum creatinine and urea nitrogen levels before and after surgery, postoperative renal function and urine output recovery time between two groups were recorded and compared. Results After surgery, serum creatinine and urea nitrogen levels in two groups were lower than those before surgery, with statistical differences (P < 0.05). Serum creatinine and urea nitrogen levels in two groups before and after surgery were compared, with no statistical differences (P > 0.05). Postoperative renal function and urine output recovery time in control group was (7.98±1.32), (7.23±1.54)d respectively, postoperative renal function and urine output recovery time in observation group was (6.14±1.99), (6.38±1.33)d respectively, the differences were highly statistically significant (P < 0.01). Conclusion Percutaneous nephrolithotomy with holmium laser lithotripsy and double positioning in vitro lithotripsy in clinical indicator have no significant difference, but patients with long time existence calculi or urethra narrow and there severe adhesion with relevant organization, should be preferred percutaneous nephrolithotomy with holmium laser lithotripsy, in order to improve postoperative recovery time and to ensure maximum completely get rid of stone.