Can Kidney Stones Cause Kidney Failure?

Preventing kidney stones is key to lowering your risk of chronic kidney disease.

If someone you know has had a kidney stone, then you probably heard them describe the excruciating pain. What may start out feeling like a stomachache or lower back pain can quickly become unbearable as the body tries to pass the stone.

Though painful, a kidney stone typically does not cause damage. However, early diagnosis and treatment are key.

“Over time, kidney stones that don’t pass can lead to serious complications, which increase the risk for kidney disease,” says Ira Kohn, MD, a urologist at Geisinger. “Having one kidney stone increases the risk of developing another one. The best way to keep your kidneys healthy is by doing everything you can to prevent kidney stones from developing in the first place.”

What are kidney stones?

Your kidneys filter blood and remove waste products from the body. Typically, any waste processed by the kidneys is dissolved in liquid and eventually eliminated as urine. But when there’s a high level of minerals or salt and too little liquid, clusters of crystals begin to develop and accumulate to form a kidney stone. They can vary in size, from as small as a grain of sand to a pebble to (rarely) the size of a golf ball or larger.

Kidney stones can be a sign of other health issues.

“Diseases like high blood pressure, diabetes and obesity increase the risk for kidney stones,” says Dr. Kohn. “More people are getting kidney stones, which is cause for concern because of what can happen if they keep recurring.”

Kidney stone symptoms

Kidney stones can cause a range of symptoms, which may vary in intensity depending on the size and location of the stone. Usually, kidney stones that stay in the kidney aren’t noticeable. The pain is a result of the kidney stone beginning to move from a kidney to the bladder through a tube called the ureter.

“Most people don’t know they have a kidney stone until they begin to feel severe pain in the side or abdomen,” says Dr. Kohn. “They may be diagnosed in the emergency department after experiencing severe pain.”

Kidney stone symptoms can include:

Severe pain on one side of the back or flank, which can radiate to the lower abdomen and groin
Nausea and vomiting
Blood in urine
Cloudy or foul-smelling urine
Frequent urination or persistent urge to urinate
Burning sensation during urination

If you have some of these symptoms and are having difficulty managing the pain, contact your doctor to schedule an appointment. If you develop fever or chills in addition to these symptoms, seek emergency care because kidney stones in combination with infection can be dangerous.

Can kidney stones cause kidney failure?

While kidney stones are often regarded as a manageable condition, they can lead to serious complications, including kidney failure.

In fact, people with kidney stones have nearly 2 times the risk of developing chronic kidney disease as people without kidney stones, says Dr. Kohn.

A kidney stone can block the urinary tract and cause a backup of urine, which can lead to increased risk for kidney or urinary tract infections. These complications and their treatment can cause kidney swelling, scarring and impaired kidney function. If both kidneys are affected, the risk of chronic kidney disease and even kidney failure increases significantly.

Chronic kidney disease is the gradual loss of kidney function over time. If it’s not treated properly, chronic kidney disease could progress until 1 or both kidneys stops functioning, called kidney failure. The only way to treat kidney failure is with dialysis or a kidney transplant.

“Recurrent kidney stones can cause long-term effects on kidney health,” says Dr. Kohn. “If you have a history of kidney stones, prevention and regular checkups with your doctor for evaluations and monitoring of your kidney function are important to protect your kidney health. Fortunately, long-term complications are rare and most of the time can be avoided.”

Kidney stones treatment

To confirm the diagnosis, your doctor may conduct a CT scan, ultrasound or X-ray to look at the size and location of the kidney stone. Your doctor will also ask you about your medical history and whether other family members have kidney stones.

After the diagnosis is confirmed, most patients pass the stone naturally with increased hydration or with the help of a prescription medication to relax the ureter.

“For larger stones or those causing significant pain, medical interventions may be necessary,” says Dr. Kohn. “Shockwave lithotripsy can break up the stone into smaller pieces to help it pass on its own, or in severe cases, you might need a surgical procedure to remove the stone.”

Once it’s passed, it’s very important to capture the stone and have it analyzed in a medical lab to help prevent future stone formation. There are many types of kidney stones, and each type has different causes and may require different treatment approaches.

For example, the most common stone type is calcium oxalate. Often, it’s caused by low levels of citrate, which inhibits stone formation, and high levels of calcium and oxalate in the urine. Another type, uric acid, can be caused by getting too many animal proteins and salt in your diet.

The best way to find the type of kidney stone you have is to catch it using a strainer. Your doctor also might order a stone risk profile, which includes blood tests and a 24-hour urine collection, to test them for calcium, uric acid and other substances associated with kidney stones to guide treatment and prevention recommendations.

Kidney stone prevention

“If you’ve had kidney stones, you’re more likely to get more in the future,” says Dr. Kohn. “The best way to keep your kidneys healthy is preventive treatment through diet changes and optimal hydration.”

Kidney stones develop when waste builds up in the kidneys. Hydration is vital for kidney health, as it helps dilute substances in the urine that can form stones. Drinking plenty of water helps to lower the ratio of waste to fluid passing through the kidneys.

“On average, men should get about 3.5 liters of fluids a day and women 2.5 liters a day, and more if you’re active,” says Dr. Kohn. “This includes fluids from water, other beverages and food, which typically contributes about 20% of your daily fluids.”

In addition, your doctor may recommend diet changes based on your stone risk profile to prevent kidney stones in the future. For example, a high-sodium diet increases the amount of calcium in urine, which can trigger kidney stones. Guidelines recommend limiting sodium to 2,000 milligrams per day. However, if you have a history of kidney stones, you should aim to keep sodium intake under 1,500 milligrams.

And contrary to popular belief, even if you’re a stone former, you should get recommended daily doses of calcium and vitamin D necessary for bone health, as well as decrease consumption of oxalate (found in leafy greens like spinach and Swiss chard) in your diet to help prevent oxalate stones.

Also, eat plenty of fruits and vegetables to lower acid levels in your urine and avoid eating too many animal proteins, which can pose a risk for uric acid stones.

“Kidney stones are just one risk factor that could contribute to chronic kidney disease,” says Dr. Kohn. “If you’ve had them in the past, it’s important to talk to your doctor about other risk factors and how you can prevent chronic kidney disease.”