Kidney stones can be tiny — sometimes as small as a grain of sand or rice — but they can still cause severe pain. That’s because the pain usually comes from a stone blocking or stretching the ureter (the tube that carries urine from the kidney to the bladder) as it moves through the urinary tract.
Here’s what you need to know about kidney stones, what causes them and how to treat them.
What is a kidney stone?
The kidney’s job is to clean your blood and get rid of waste through your urine. When there are too many minerals and salts in your urine and not enough water for them to dissolve in, they can stick together and form kidney stones.
The most common minerals and salts that form kidney stones are calcium, oxalate, uric acid, cystine and phosphate.
What causes kidney stones?
Kidney stones are usually caused by a combination of several factors, such as:
- Diet & Lifestyle — Not drinking enough fluids, eating a diet high in salt or animal protein, drinking a lot of sugary beverages, eating many foods high in oxalate (like spinach, beets, nuts and chocolate)
- Medications & Supplements — High-dose Vitamin C, calcium supplements (especially if taken without food), frequent laxative use, and certain medicines (for example, topiramate for migraine or seizures or some HIV medicines)
- Certain Health Conditions — Conditions such as obesity, hyperparathyroidism, chronic diarrhea or malabsorption (including inflammatory bowel disease), gout, recurrent urinary tract infections and rare genetic conditions like primary hyperoxaluria (which causes the body to make too much oxalate)
- Genetics — Having a family member who has had one or more kidney stones
What types of kidney stones are there?
There are four types of kidney stones:
- Calcium stones — Calcium stones are the most common type of kidney stone. Many are calcium oxalate stones. Oxalate is made by the body and is also found in some foods (like spinach, nuts and chocolate). Calcium phosphate stones are less common and may be linked to certain metabolic conditions or medicines (including some used for migraine prevention or seizures).
- Uric acid stones — Uric acid stones can form when urine is consistently acidic. Risk factors include gout, dehydration, chronic diarrhea, diabetes and eating a diet high in purines (found in foods like organ meats and some shellfish).
- Struvite stones — Struvite stones (sometimes called infection stones) can form after a urinary tract infection caused by certain bacteria. They can grow quickly and become large.
- Cystine stones — Cystine stones are caused by a rare, genetic condition called cystinuria, which causes too much cystine to leak into your urine.
What are symptoms of kidney stones?
Kidney stones can cause symptoms once they move into the ureter — the tubes that connect the kidneys to the bladder. One of the first symptoms is sudden, severe pain, including:
- Sharp pain in the side and back, below the ribs
- Pain that spreads to the lower stomach and groin
- Pain or a burning feeling when urinating
The pain can also come and go and change in how much it hurts. And as the kidney stone moves through the urinary tract, the pain might also move with it.
Other symptoms of a kidney stone include:
- Pink, red or brown urine
- Cloudy or foul-smelling urine
- A constant feeling that you need to urinate, urinating more often than usual or urinating in small amounts
- Nausea or vomiting
- Fever and chills (If you experience fever and chills, seek medical care right away. This can be a sign of infection.)
Do kidney stones cause complications?
Most people recover from kidney stones without lasting problems. But sometimes they can cause complications, especially if they block urine flow or lead to infection. People with recurrent stones may also have a higher risk of chronic kidney disease. Research has also found links between kidney stones and conditions like high blood pressure, cardiovascular disease and lower bone density — but these links don’t necessarily mean stones directly cause them
What are kidney stone treatments?
Most kidney stones pass on their own when you urinate. This process can be very uncomfortable or painful, so your healthcare provider might prescribe medications to help the stones pass more easily and to reduce nausea, vomiting and pain.
If the kidney stones are too large to pass on their own, you will likely need a procedure to break them up or remove them.
Shockwave lithotripsy — Uses soundwaves to break a stone into smaller pieces so they can pass in urine.
Ureteroscopy — A thin scope is passed through the urethra and bladder into the ureter. A laser can break up the stone, and pieces may be removed with a small basket. A temporary stent is sometimes placed to keep urine flowing while swelling goes down.
Percutaneous nephrolithotomy — Used for larger or complex stones. A surgeon makes a small incision in your back and uses a scope to reach the kidney, break up the stone and remove pieces.
Laparoscopic or open surgery — Surgery for kidney stones is rarely needed today, but may be used in select cases when other treatments aren’t an option.
This educational resource was created with support from Alnylam.
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