Kidney Stones (Nephrolithiasis): Symptoms, Causes, and Treatment — Symptoms, Causes & Treatment

Kidney stones are hard mineral and salt deposits that form inside your kidneys, a condition called nephrolithiasis. While some stones pass without notice, larger ones can cause excruciating pain and may require medical intervention. Understanding the causes and symptoms is key to managing the condition and preventing future stones. Seek immediate medical care for severe pain accompanied by fever, chills, or inability to urinate.

Kidney Stones (Nephrolithiasis): Symptoms, Causes, and Treatment Kidney stones, also known as nephrolithiasis or urolithiasis, are hard deposits made of minerals and salts that form inside your kidneys. These stones can vary in size, from as small as a grain of sand to as large as a pearl, and can affect any part of your urinary tract, from your kidneys to your bladder. While often asymptomatic when small, larger stones can cause significant pain and complications as they move through the urinary system. Symptoms Severe pain in the side and back, below the ribs (renal colic) Pain that radiates to the lower abdomen and groin Painful urination (dysuria) Pink, red, or brown urine (hematuria) Nausea and vomiting Frequent urge to urinate Fever and chills if an infection is present Causes and Risk Factors Kidney stones often form when your urine becomes concentrated, allowing minerals to crystallize and stick together. Common causes and risk factors include: Dehydration: Not drinking enough water is a major risk factor, as it leads to more concentrated urine. Diet: Diets high in sodium, animal protein, and sugar can increase the risk of certain types of kidney stones. Medical Conditions: Certain conditions like inflammatory bowel disease, urinary tract infections, and some genetic disorders can predispose individuals to kidney stone formation. Family History: Having a family member with kidney stones increases your own risk. When to See a Doctor It is crucial to seek medical attention if you experience severe pain that prevents you from finding a comfortable position, blood in your urine, difficulty urinating, or if your pain is accompanied by fever and chills. These symptoms could indicate a larger stone, an infection, or other complications that require prompt diagnosis and treatment. A healthcare professional can accurately diagnose kidney stones through imaging tests and urine analysis, and recommend appropriate treatment options, which may range from pain management and increased fluid intake to medical procedures for stone removal.

Early symptoms

Sharp pain in the side and back (renal colic)
Pain that radiates to the lower abdomen and groin
Pain that comes in waves and fluctuates in intensity
Pain or burning sensation during urination (dysuria)
Pink, red, or brown urine (hematuria)
Cloudy or foul-smelling urine
Persistent need to urinate, urinating more often than usual, or urinating in small amounts
Nausea and vomiting

Severe symptoms — seek medical care

Severe, unbearable pain that makes it impossible to sit still or find a comfortable position
Pain accompanied by fever and chills (sign of infection)
Complete inability to pass urine (anuria)
Persistent vomiting preventing you from keeping fluids down

Common causes

Low fluid intake (dehydration)
High concentration of stone-forming substances in urine (calcium, oxalate, uric acid)
High-sodium, high-sugar, or high-protein diets
Obesity
Certain medical conditions (gout, hyperparathyroidism, inflammatory bowel disease)
Family history or personal history of kidney stones
Urinary tract infections (for struvite stones)

Frequently Asked Questions

Are kidney stones serious or dangerous?

Kidney stones can range from a minor nuisance to a serious medical emergency. Small stones may pass on their own with minimal discomfort. However, larger stones can cause excruciating pain and become lodged in the urinary tract, leading to complications. The most serious risks occur when a stone causes a complete blockage of urine flow or is accompanied by an infection. A blocked, infected kidney (urosepsis) is a life-threatening condition requiring immediate medical intervention [3]. Therefore, while a single, small stone may not be dangerous, symptoms like high fever, unbearable pain, or an inability to urinate should always be treated as an emergency.

Can kidney stones be cured or will I get them again?

The immediate problem of a kidney stone can be resolved, either by passing it naturally or through medical procedures, which can be considered a 'cure' for that specific stone. However, having one kidney stone significantly increases your risk of forming another. Research shows that without preventive measures, the recurrence rate can be as high as 50% within 5 to 10 years [1]. The key to preventing recurrence is identifying the type of stone you form and making specific lifestyle changes, such as increasing fluid intake and modifying your diet. In some cases, medication may be prescribed for long-term prevention.

How long does it take to pass a kidney stone?

The time it takes to pass a kidney stone varies greatly depending on its size and location. Generally, smaller stones (less than 4 mm) have about an 80% chance of passing on their own, often within a few days to a couple of weeks. Larger stones (4-6 mm) may take longer and have a lower chance of passing spontaneously. Stones larger than 6 mm are much less likely to pass without medical help. Your doctor might prescribe an alpha-blocker like tamsulosin to relax the ureter and speed up the process [4]. If a stone hasn't passed within 4-6 weeks or is causing severe symptoms, a medical procedure is usually recommended.

Can I work or exercise with a kidney stone?

Whether you can work or exercise depends entirely on your symptoms. If you are experiencing the severe pain of renal colic, it is often debilitating and makes normal activities, including work, impossible. During these acute phases, rest is essential. However, if you have a small stone with minimal or no symptoms, you can likely continue your normal routine. Light exercise, such as walking, can even be beneficial and may help the stone pass. It's crucial to stay well-hydrated, especially during exercise. Avoid strenuous activity during an acute pain episode and always consult your doctor for personalized advice.

Are kidney stones hereditary?

Yes, there is a significant genetic component to kidney stone formation. If you have a close family member, such as a parent or sibling, with a history of kidney stones, your own risk is more than two times higher than that of the general population [6]. This is partly due to inherited tendencies to excrete high levels of calcium or other stone-forming substances in the urine. Additionally, rare genetic disorders, like cystinuria (which causes cystine stones) and primary hyperoxaluria, are directly responsible for stone formation. If you have a family history, it is especially important to focus on preventive strategies like hydration and diet.

What foods should I eat or avoid to prevent kidney stones?

Dietary recommendations depend on the type of stone you form, but some general advice applies to most. The single most important step is to drink enough fluid, primarily water, to produce at least 2.5 liters of urine per day [2]. For preventing the most common type, calcium oxalate stones, it's crucial to reduce sodium intake, as high sodium causes your kidneys to excrete more calcium into the urine. You should also moderate your intake of animal protein. While it may seem counterintuitive, consuming a normal amount of dietary calcium is important; pairing calcium-rich foods with oxalate-rich foods (like spinach, nuts, beets) in the same meal can help bind oxalate in the gut and prevent its absorption. Your doctor or a dietitian can provide a personalized plan after analyzing your stone and urine.

How do I know if my treatment for kidney stones is working?

If you are being treated for an acute kidney stone, the primary sign of success is the passing of the stone, often accompanied by a sudden relief of pain. You might even see the stone in your urine. If you've had a medical procedure like lithotripsy or ureteroscopy, a follow-up imaging test (like an X-ray or CT scan) will be used to confirm that all stone fragments have been cleared. For long-term preventive treatment, success is measured by the absence of new stones. Your doctor will monitor this through periodic imaging and 24-hour urine tests to ensure that the levels of stone-forming substances are within a safe range [1].

Are there any effective natural or home remedies for kidney stones?

The most effective and scientifically supported 'natural' remedy is aggressive hydration. Drinking plenty of water dilutes your urine and helps flush out small stones and prevent new ones from forming. Another well-regarded home remedy is increasing your intake of citrate, found in citrus fruits like lemons, limes, and oranges. Citrate binds to calcium in the urine and makes the urine less acidic, both of which help prevent stone formation [2]. Adding fresh lemon juice to your water is a simple way to do this. While many other herbal remedies are promoted online, such as Chanca Piedra ('stone breaker'), scientific evidence for their effectiveness in humans is limited and they should not replace medical advice.

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