A 25-year-old man presented with stones in left kidney received the left Percutaneous nephrolithotomy (PCNL) with holmium laser lithotripsy. All the stones were successfully removed, and all the results were normal in the first three months followup. However, a deterioration of renal function was confirmed two years later. No mechanical obstruction was found with ureteroscopy. The deterioration of renal function may be induced by high internal renal pelvis pressure, injury of the laser energy, potential functional obstruction, and/or ischemia-reperfusion injury.