The tumors that affect bladder, prostate and testis in children are rare. Here we report a case of bladder rhabdomyosarcoma presenting with hypertension and acute renal failure. Acute renal failure and hypertension have been treated successfully by appropiate medical and surgical interventions but the current problem is chronic renal failure and recurrent urinary tract infections. Beyond multiple difficult problems of a cancer patient confronting the pediatric oncologist we want to emphasize an additional nephro-urological morbidity. The causes of renal functional impairment in patients with bladder rhabdomyosarcoma are discussed. The importance of nephro-urological problems and the clinical value of nephrological follow-up in cancer patients is emphasized.