Renal calculi; Nephrolithiasis; Stones - kidney; Calcium oxalate - stones; Cystine - stones; Struvite - stones; Uric acid - stones; Urinary lithiasis A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time. The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
 This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
Kidney stones result when urine becomes too concentrated and substances in the urine crystalize to form stones. Symptoms arise when the stones begin to move down the ureter causing intense pain. Kidney stones may form in the pelvis or calyces of the kidney or in the ureter.
In the procedure intravenous pyelogram (IVP), the patient is injected with radiopaque dye and X-rays are taken as the dye travels through the urinary tract. This procedure is performed to confirm the presence of kidney stones, although some stones may be too small to see.
Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to shatter simple stones in the kidney or upper urinary tract. Ultrasonic waves are passed through the body until they strike the dense stones. Pulses of sonic waves pulverize the stones, which are then more easily passed through the ureter and out of the body in the urine.
If you ever have severe pain in your belly or one side of your back that comes and goes suddenly, you may be passing a kidney stone. Let's talk about the painful condition of kidney stones. A kidney stone is a mass of tiny crystals in your kidney or urinary tract. Stones are quite common, and tend to run in families. They can form in weeks or months when your urine contains too much of certain substances. There are several kinds of kidney stones. Calcium stones are by far the most common kind. They often form in men between the ages of 20 to 30. Calcium can combine with other substances found in your food, like oxalate, phosphate, or carbonate, to form stones. Cystine stones can form in people who have cystinuria, a condition passed down through families in which stones are made from an amino acid called cystine. Struvite stones are found mostly in women who have urinary tract infections. These stones can grow very large and can block the kidney, ureter, or bladder. Uric acid stones are more common in men than in women. They can occur in people who have a history of gout or are going through chemotherapy. So, how do you know if you have kidney stones? Well, you may not have symptoms until the stone move down the ureter tubes through which urine empties into your bladder. When this happens, the stones can block the flow of urine out of your kidneys. The main symptom is severe sharp pain that starts suddenly, usually in your belly or one side of your back, and it may go away just as quickly. Other symptoms can include abnormal urine color, blood in your urine, fever, chills, nausea, and vomiting. So, what do you do about kidney stones? Well, your health care provider will perform a physical exam. You may need blood tests, kidney function tests, and tests that look for crystals in your urine. Several imaging tests, like a CT scan, can see stones or a blockage in your urinary tract. Treatment will depend on the type of stone you have, and how bad your symptoms are. Small kidney stones that are less than 5 mm in diameter will usually pass on their own. You should drink at least 6 to 8 glasses of water per day to produce a large enough amount of urine to help bring the stone out. Pain can be pretty bad when you pass a kidney stone, so your doctor may prescribe pain medicines to help as well as medications that will help the stone pass. Other medicines can decrease stone formation or help break down and remove the material that is causing you to make stones. You may need surgery if the stone is too large to pass, the stone is growing, or the stone is blocking your urine flow. Kidney stones are painful, but you can usually pass them without causing permanent harm. However, kidney stones often come back, so you and your doctor will need to work on finding the cause of your stone. Lastly, delaying treatment can lead to serious complications, so if you think that you have kidney stones see your doctor right away.
Kidney stones are common. Some types run in families. They often occur in premature infants. There are different types of kidney stones. The cause of the problem depends on the type of stone. Stones can form when urine contains too much of certain substances that form crystals. These crystals can develop into stones over weeks or months.
Calcium stones can also form from combining with phosphate or carbonate. Other types of stones include:
The biggest risk factor for kidney stones is not drinking enough fluids. Kidney stones are more likely to occur if you make less than 1 liter (32 ounces) of urine a day.
You may not have symptoms until the stones move down the tubes (ureters) through which urine empties into your bladder. When this happens, the stones can block the flow of urine out of the kidneys. The main symptom is severe pain that starts and stops suddenly:
Other symptoms can include:
The health care provider will perform a physical exam. The belly area (abdomen) or back might feel sore. Tests that may be done include:
Stones or a blockage can be seen on:
Treatment depends on the type of stone and the severity of your symptoms. Kidney stones that are small most often pass through your system on their own.
Some people with severe pain from kidney stones need to stay in the hospital. You may need to get fluids through an IV into your vein. For some types of stones, your provider may prescribe medicine to prevent stones from forming or help break down and remove the material that is causing the stone. These medicines can include:
Surgery is often needed if:
Today, most treatments are much less invasive than in the past.
Talk to your provider about what treatment options may work for you. You will need to take self-care steps. Which steps you take depend on the type of stone you have, but they may include:
Kidney stones are painful, but most of the time can be removed from the body without causing lasting damage. Kidney stones often come back. This occurs more often if the cause is not found and treated. You are at risk for:
Complication of kidney stones may include the obstruction of the ureter (acute unilateral obstructive uropathy).
Contact your provider if you have symptoms of a kidney stone:
If you have been diagnosed with blockage from a stone, passage must be confirmed either by capture in a strainer during urination or by follow-up x-ray. Being pain free does not confirm that the stone has passed.
If you have a history of stones:
American Urological Association website. Medical management of kidney stones (2019). www.auanet.org/guidelines/kidney-stones-medical-mangement-guideline. Updated 2019. Accessed May 25, 2022. American Urological Association website. Surgical management of stones: AUA/Endourology Society guideline (2016) www.auanet.org/guidelines/kidney-stones-surgical-management-guideline. Updated 2016. Accessed May 25, 2022. Bushinsky DA. Nephrolithiasis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 117. Fink HA, Wilt TJ, Eidman KE, et al. Recurrent nephrolithiasis in adults: comparative effectiveness of preventive medical strategies. Rockville, MD. Agency for Healthcare Research and Quality (US) 2012;Report No.:12-EHC049-EF. PMID: 22896859 pubmed.ncbi.nlm.nih.gov/22896859/. Miller NL, Borofsky MS. Evaluation and medical management of urinary lithiasis. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 92.
Last reviewed on: 1/1/2022 Reviewed by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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