During the onset of diabetic ketoacidosis (DKA), the appearance of hyperchromic urines is a rare occurrence even if already described in the literature. The patient with DKA presents an increased risk to suffer of macrohaematuria due to nephrolithiasis (associated or not with urinary tract infections) and renal vein thrombosis. False macrohaematuria in rhabdomyolysis with myoglobinuria can also occur. This paper describes a case of an 11-year-old boy with severe onset of DKA, with macrohaematuria from kidney stones. The causes of nephrolithiasis in children with DKA are also reported.