A kidney stone is a hard deposit that develops when certain substances in urine become sufficiently concentrated to form crystals. Stones can develop in one or both kidneys and may remain there without causing symptoms or move into the ureter, where they can obstruct urine flow and cause significant pain.

Kidney stones vary considerably in size, composition and location. A very small stone may pass through the urinary tract without treatment, while a larger or obstructing stone may require active treatment.

For this reason, kidney stone causes, symptoms and treatment should be considered together rather than treating every stone in exactly the same way.

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized kidney evaluation for patients with stones, recurrent stone formation and associated kidney-function concerns.

How Do Kidney Stones Form?

Stone formation begins when the urine contains more of certain stone-forming substances than can remain dissolved.

Depending on the type of stone, these substances may include:

• Calcium

• Oxalate

• Phosphate

• Uric acid

• Cystine

Low urine volume can also make urine more concentrated and increase the opportunity for crystals to form.

A crystal may gradually enlarge and combine with other crystals, eventually forming a stone.

Main Types of Kidney Stones

Knowing the stone type can be important because prevention and, in some cases, treatment differ according to composition.

Calcium Stones

Calcium stones are the most common type and include calcium oxalate and calcium phosphate stones.

Factors associated with calcium stone formation can include increased urinary calcium, increased oxalate, low urinary citrate and other metabolic abnormalities.

Uric Acid Stones

These stones can develop when urine is excessively acidic and may be associated with high uric acid levels.

Dietary and metabolic factors can contribute to their formation.

Struvite Stones

Struvite stones can occur in association with certain urinary infections and may grow relatively quickly.

Cystine Stones

Cystine stones are associated with cystinuria, an inherited disorder that causes cystine to enter the urine in excessive amounts.

Common Causes and Risk Factors for Kidney Stones

Kidney stones usually result from a combination of urinary, metabolic, dietary and genetic factors rather than one single cause.

Important risk factors may include:

• Not drinking enough fluid

• High concentrations of stone-forming minerals in urine

• Family history of kidney stones

• Previous kidney stones

• Obesity

• Certain dietary patterns

• Recurrent urinary infections

• Hyperparathyroidism

• Excess urinary calcium

• Excess urinary oxalate

• Excess urinary uric acid

• Certain intestinal or digestive disorders

• Some inherited conditions

• Certain medicines

• Urinary tract abnormalities

People who have already had a kidney stone are at increased risk of developing another stone.

Does Drinking Too Little Water Cause Kidney Stones?

Inadequate fluid intake is an important risk factor.

When the body produces less urine, stone-forming substances become more concentrated. This can make crystal formation more likely.

People who lose substantial fluid through sweating, particularly in hot weather or during intense physical activity, may need to pay particular attention to hydration.

However, fluid recommendations should be individualized for people with kidney failure, heart disease or prescribed fluid restrictions.

Can Food Cause Kidney Stones?

Diet can influence stone risk, but there is no single food that causes every kidney stone.

Depending on stone type and metabolic findings, a healthcare professional may recommend changes involving:

• Sodium

• Animal protein

• Oxalate

• Calcium intake

• Overall fluid intake

For example, higher sodium intake can increase kidney stone risk, while appropriate dietary calcium can actually be helpful for preventing some calcium oxalate stones.

Therefore, unnecessarily eliminating calcium or following an extreme diet without knowing the stone type may be counterproductive.

Early Kidney Stone Symptoms

Some stones cause no symptoms at all.

When a stone begins moving or interferes with urine flow, symptoms may develop.

Possible early or initial symptoms include:

• Discomfort in the side or back

• Intermittent flank pain

• Pain that moves toward the lower abdomen

• Urinary urgency

• Burning during urination

• Blood in urine

• Increased urinary frequency

The exact symptoms depend largely on the stone's position within the urinary tract.

What Does Kidney Stone Pain Feel Like?

Kidney stone pain is often described as sudden, intense pain in the:

• Side

• Flank

• Back

• Lower abdomen

• Groin

The pain may come in waves and can change location as the stone moves down the ureter. Nausea and vomiting may accompany severe pain.

Importantly, pain severity does not reliably tell you how large the stone is.

A smaller stone can cause severe pain if it obstructs the ureter, while a larger kidney stone may sometimes produce few symptoms.

Other Symptoms of Kidney Stones

In addition to pain, kidney stones may cause:

• Pink, red or brown urine

• Blood detected on urine testing

• Pain during urination

• Frequent urge to urinate

• Passing only a small amount of urine

• Cloudy urine

• Bad-smelling urine

• Nausea

• Vomiting

Fever and chills can indicate infection and should receive prompt medical attention, particularly when a stone may be blocking urine flow.

Can Kidney Stones Cause Blood in Urine?

Yes.

A moving stone can irritate or injure the urinary tract and cause hematuria, meaning blood in the urine.

The blood may be:

• Clearly visible

• Pink or reddish

• Brownish

• Detected only through urine testing

However, blood in urine can have many causes besides kidney stones, so it should not automatically be attributed to a stone.

Can Kidney Stones Cause Urinary Problems?

Yes.

A stone entering the ureter can interfere with normal urine drainage.

Depending on its location, it may cause:

• Urgency

• Frequency

• Burning

• Reduced urine flow

• Difficulty passing urine

• Partial or complete obstruction

A significant obstruction can increase pressure within the urinary tract and potentially affect kidney function.

When Can a Kidney Stone Become Dangerous?

A kidney stone requires particularly urgent assessment when it is associated with:

• Fever or chills

• Suspected urinary infection

• Very little or no urine

• Severe persistent pain

• Repeated vomiting

• Significant urinary obstruction

• Declining kidney function

• A single functioning kidney

An infected obstructed urinary tract can become a medical emergency and may require urgent drainage before definitive stone removal.

How Are Kidney Stones Diagnosed?

Diagnosis involves more than identifying pain alone.

A doctor may assess the patient's history, symptoms, physical findings, laboratory results and imaging.

Urine Examination

Urinalysis can help identify:

• Blood

• White blood cells

• Bacteria

• Crystals

• Other abnormalities

Urine testing may also help identify infection or clues about the type of stone.

Blood Tests

Depending on the situation, testing may include:

• Creatinine

• eGFR

• Electrolytes

• Calcium

• Uric acid

• Blood count

• Other metabolic tests

These tests can help determine whether the stone is affecting kidney function or whether an underlying metabolic problem may be contributing.

Ultrasound

Ultrasound can help identify many urinary stones and detect urinary tract dilation or obstruction.

It is particularly useful in selected situations where avoiding radiation is desirable.

CT Scan

A non-contrast CT scan can provide detailed information about:

• Stone size

• Stone location

• Number of stones

• Urinary obstruction

• Surrounding urinary anatomy

The appropriate imaging test depends on the patient's symptoms and clinical circumstances.

Does Every Kidney Stone Need Treatment?

No.

Treatment depends on factors such as:

• Stone size

• Stone location

• Stone composition

• Symptoms

• Likelihood of spontaneous passage

• Urinary obstruction

• Infection

• Kidney function

Small stones may pass naturally, whereas larger, obstructing or severely symptomatic stones may require active treatment.

Kidney Stone Treatment Options

Observation

Selected small stones without complications may be monitored while allowing time for spontaneous passage.

The doctor may recommend symptom control and appropriate fluid intake.

Medicines

Medicines may be prescribed for:

• Pain control

• Nausea

• Selected ureteral stones to facilitate passage

• Prevention of future stones

The appropriate medicine depends on stone characteristics and the patient's health.

Patients with kidney disease should not self-medicate with painkillers or stone medicines.

Shock Wave Lithotripsy

Shock wave lithotripsy (SWL or ESWL) uses externally generated shock waves to break a stone into smaller fragments that can subsequently pass through the urinary tract.

Whether SWL is appropriate depends on factors such as stone size, location, composition, anatomy and other patient-specific considerations.

Ureteroscopy and Laser Lithotripsy

During ureteroscopy, a thin instrument is passed through the urinary tract to reach the stone.

The stone can then be removed or fragmented, often using laser energy.

This approach can be used for selected stones in the ureter or kidney.

Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy (PCNL) involves creating a small access tract through the back into the kidney.

A nephroscope is used to locate and remove the stone, with fragmentation techniques used when necessary.

PCNL is commonly considered for larger kidney stones.

Can Kidney Stones Be Treated Without Surgery?

Some small stones can pass naturally without a procedure.

However, the phrase “kidney stone treatment without surgery” should not be interpreted as meaning that every stone can be treated with tablets or home remedies.

A large, obstructing, infected or persistent stone may require a procedure to protect the urinary tract and kidney function.

The decision should be based on imaging and clinical assessment.

Do Medicines Dissolve Kidney Stones?

Most kidney stones cannot simply be dissolved with a tablet.

Treatment depends on stone composition.

Certain uric acid stones, for example, may be amenable to medically supervised urine alkalinization.

Other stone types generally require passage, fragmentation or physical removal when active treatment is necessary.

Therefore, identifying or strongly suspecting the stone type can be useful when planning prevention and treatment.

Can Drinking More Water Flush Out a Kidney Stone?

Appropriate hydration can help maintain urine flow and is important for prevention.

However, drinking excessive amounts of water does not guarantee that a large or obstructing stone will pass.

If there is significant obstruction, forcing large amounts of fluid may worsen discomfort without resolving the blockage.

People with kidney failure, heart failure or fluid restrictions should follow their clinician's fluid plan rather than increasing intake independently.

What Happens After a Kidney Stone Is Removed?

Stone treatment should ideally be followed by an effort to understand why the stone formed.

The removed stone or passed fragments may be analyzed to determine composition.

In selected patients, a 24-hour urine evaluation can assess:

• Urine volume

• Calcium

• Oxalate

• Citrate

• Uric acid

• Other stone-forming factors

This information can help create a prevention plan.

How Can Future Kidney Stones Be Prevented?

Prevention depends on the type of stone and individual risk factors.

General measures may include:

Maintain Appropriate Fluid Intake

Adequate fluid intake helps dilute urine and reduce the concentration of stone-forming substances.

Reduce Excess Sodium

A high-sodium diet can increase the risk of certain calcium stones.

Reducing excessive salt intake may therefore be recommended.

Follow the Right Protein Intake

Depending on stone type, excessive animal protein may increase stone risk.

Protein intake should be individualized rather than eliminated.

Do Not Unnecessarily Avoid Dietary Calcium

For calcium oxalate stone prevention, appropriate dietary calcium can help reduce absorption of oxalate in the intestine.

Address the Specific Stone Type

Uric acid, calcium, struvite and cystine stones require different prevention strategies.

Treat Recurrent Urinary Infections

Recurrent infections can contribute to certain types of stones, particularly struvite stones.

Can Kidney Stones Damage the Kidneys?

Most kidney stones do not cause permanent kidney damage when appropriately managed.

However, untreated stones can lead to complications such as:

• Persistent obstruction

• Recurrent urinary infection

• Severe pain

• Blood in urine

• Loss of kidney function in complicated cases

The risk is greater when obstruction is prolonged or infection is present.

When Should You See a Kidney or Urinary Stone Specialist?

Medical evaluation is appropriate if you have:

• Recurrent kidney stones

• Persistent flank pain

• Blood in urine

• A stone that is not passing

• Repeated urinary infections

• Known urinary obstruction

• Reduced kidney function

• A large kidney stone

• Stones in both kidneys

• A single functioning kidney

Stone treatment often involves a urologist for procedural management, while a nephrologist may be involved when there are kidney-function abnormalities, recurrent metabolic stone problems or associated kidney disease.

Kidney Stone Evaluation at Prabhakar Bhurke Clinic

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized evaluation for patients with kidney stones and related kidney-function concerns.

Depending on the patient's situation, assessment may include:

• Review of previous stone episodes

• Kidney-function testing

• Creatinine and eGFR evaluation

• Urine examination

• Assessment of protein or blood in urine

• Review of ultrasound or CT findings

• Evaluation for urinary obstruction

• Assessment of recurrent stone risk

• Metabolic evaluation when appropriate

• Medical management of kidney-related complications

• Coordination with a urologist when procedural stone removal is required

The appropriate treatment plan depends on the patient's stone characteristics, kidney function and overall health.

Frequently Asked Questions

What are the main causes of kidney stones?

Common contributors include concentrated urine, low fluid intake, high urinary levels of calcium, oxalate or uric acid, certain metabolic conditions, recurrent urinary infections, inherited disorders, dietary factors and some medicines.

What are the first symptoms of kidney stones?

Some stones cause no symptoms. When symptoms develop, they may include flank or back pain, urinary discomfort, blood in urine, urinary urgency, nausea or vomiting.

What is the best treatment for kidney stones?

There is no single treatment that is best for every stone. Observation, medicines, SWL, ureteroscopy with laser treatment or PCNL may be appropriate depending on the stone's size, location, composition and clinical circumstances.

Can a kidney stone pass naturally?

Some small stones can pass without a procedure. Larger stones are less likely to pass and may become stuck or obstruct urine flow.

Can kidney stones be cured permanently?

An existing stone can often be removed or passed, but the tendency to form stones can remain. Identifying the stone type and addressing metabolic and lifestyle risk factors can help reduce recurrence.

Does drinking water prevent kidney stones?

Adequate fluid intake can help dilute urine and is an important part of prevention for many people. However, fluid needs should be individualized in patients with kidney failure, heart disease or other fluid restrictions.

Are kidney stones dangerous?

Many stones are manageable, but a stone causing infection, significant obstruction, severe symptoms or declining kidney function can become serious and requires prompt medical evaluation.

Can kidney stones cause kidney failure?

Complicated or prolonged obstruction, particularly when associated with infection or other kidney disease, can impair kidney function. Prompt evaluation helps reduce the risk of complications.

Conclusion

Kidney stone causes, symptoms and treatment vary considerably from one person to another. Stones form when certain substances become concentrated in urine and crystallize, with factors such as low fluid intake, metabolic abnormalities, diet, genetics and certain medical conditions influencing risk.

Symptoms can range from no symptoms at all to severe flank pain, blood in urine, urinary problems, nausea and vomiting. Fever or chills in someone with suspected obstruction requires urgent medical attention because an infected blocked urinary tract can be dangerous.

Treatment is selected according to stone size, location, composition, symptoms, obstruction and kidney function. Some small stones can pass naturally, while others may require medicines, shock wave lithotripsy, ureteroscopy with laser treatment or PCNL.

After a stone is treated, identifying why it formed can be just as important as removing it. Appropriate hydration, dietary adjustments, metabolic evaluation and preventive medicines when indicated can reduce the likelihood of recurrence.

For individualized evaluation of kidney stones and related kidney-function concerns, consult Dr. Sandip Prabhakar Bhurke at Prabhakar Bhurke Clinic.

Medical Disclaimer

This article is intended for general educational and informational purposes only and should not be considered a substitute for professional medical diagnosis, treatment or individualized medical advice. Kidney stone symptoms can overlap with urinary, abdominal and other medical conditions. Treatment depends on stone size, location, composition, obstruction, infection, kidney function and the patient's overall health. Do not start prescription medicines, antibiotics, painkillers, supplements or stone remedies without professional guidance. Do not attempt to force an obstructing stone to pass by drinking excessive amounts of water. Seek urgent medical attention for fever or chills with suspected kidney stone, very little or no urine, severe persistent pain, repeated vomiting, severe weakness or rapidly worsening symptoms. Consult Dr. Sandip Prabhakar Bhurke or an appropriately qualified kidney or urinary stone specialist for personalized evaluation.