Can kidney stones cause kidney failure?

Can kidney stones cause kidney failure cartoon

In addition to causing pain, can kidney stones actually cause permanent damage to your kidney? The unfortunate answer is yes, kidney stones in some cases can actually result in a “dead” kidney or kidney failure. The good news though is that this doesn’t happen very often and it often takes a long time to occur, providing the opportunity for treatment to occur before permanent damage occurs.

Kidney stones can cause kidney damage in two primary ways.

1) An untreated obstructing stone that causes persistent severe blockage instead of successfully passing can eventually cause atrophy in a kidney, resulting in a dilated, thinned out kidney with minimal function.

Thankfully, because most stones are associated with significant amounts of pain, most patients will seek treatment long before permanent damage can occur. However, in cases where patients have “silent” stones that cause little or no pain, long term obstruction can occasionally lead to kidney damage. With no symptoms to warn them, these patients often go months to years before a stone is diagnosed.

The CT scan below demonstrates a left kidney which has been damaged by a large obstructing left ureteral stone. For comparison, note the normal size right kidney. The patient did not have any symptoms of pain and the stone was found after the CT scan was obtained for the finding of blood in the urine.

CT scan of an atrophic left kidney from a ureteral stone

2) Infection related stones, usually composed of struvite and sometimes presenting as a complete “staghorn” can lead to ongoing chronic urinary tract infections that cause damage slowly through inflammation and scarring of the kidney tissue.

The CT scan below demonstrates an atrophic right kidney due to a large “staghorn” infection stone. This patient also has left kidney stones and presented with recurrent infections and left sided back pain.

CT scan of staghorn stone in an atrophic right kidney

How often do kidney stones cause kidney failure?

Cause of kidney failure in the United States (2009)

 

The most recent data from the United States Renal Data System indicates that “other urologic diseases” (which would include stones) was the cause in 2% of cases of kidney failure in the United States. The two most common causes of kidney failure were diabetes and high blood pressure. In the United States, there was a total of 571,414 Americans with kidney failure in 2009. 116,395 new cases of kidney failure developed during the year. Consistent with this US data, kidney stones were also reported to be the cause of kidney failure in 1 to 3% of all patients undergoing dialysis in two studies from France and Tunisia.

Chronic kidney disease occurs when the kidneys do not work normally. The kidneys’ job in the body is to filter blood, remove waste, and regulate salt and water. If chronic kidney disease is severe enough such that the kidneys stop working completely (>90% of function lost), it is called kidney failure or “end stage renal disease”.  In these cases, patients require replacement kidney treatment through dialysis or a kidney transplant.

One reason why kidney stones don’t often cause chronic kidney disease or failure more often is because in most cases, kidney stones will cause damage to only one kidney. Patients whose other kidney is healthy will usually not develop kidney failure. Exceptions to this can occur in cases of kidney stones affecting both kidneys, large infection stones occurring in both kidneys, certain congenital causes of kidney stones, and in patients with only one kidney (40% of patients with kidney failure from kidney stones in the study from France had only one functional kidney).

Stone types causing kidney failure in a study of 45 patients (Paris, France).

Stone Type Percentage of cases
Struvite (infection) 42.2%
Calcium based 26.7%
Uric acid 17.8%
Congenital (hyperoxaluria type 1and cystinuria) 13.3%

How can I avoid developing kidney damage from my stones?

The good news is that for the vast majority of kidney stone patients, significant kidney damage is unlikely. To be on the safe side, there are a few steps you can take.

  • If you develop a stone episode but do not pass a stone or undergo treatment within a few months, you may want to consider getting followup imaging with your doctor to insure that the stone has actually passed and is not causing persistent obstruction. This is more of a concern for larger stones (greater than 6mm or so).
  • Patients with large infection related stones (struvite) are at increased risk for kidney damage from their stones. They should be sure to have their stones treated and need followup to insure infections and stones do not return.
  • Work with your doctor to prevent future stones. A prevention plan may include testing for the reason why you are forming stones, diet changes, or in certain cases, medications.

References

Floege: Comprehensive Clinical Nephrology, 4th ed.

Jungers and colleagues, “ESRD caused by Nephrolithiasis: Prevalence, Mechanisms, and Prevention”. American Journal of Kidney Diseases 2004.

Ounissi and colleagues, “Nephrolithiais-induced end stage renal disease”. International Journal of Nephrology and Renovascular Disease.

U S Renal Data System, USRDS 2011 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2011.

About Dr. Mike Nguyen

Mike M Nguyen, MD, MPH, is a urologist and an Associate Professor of Clinical Urology at the Keck School of Medicine of USC in Los Angeles, CA. He specializes in the treatment of kidney stones with both surgery and dietary prevention and the in the treatment of kidney and prostate cancer using the latest robotic and laparoscopic surgical approaches. He sees patients patients at USC-Keck urology clinics located in Los Angeles, Pasadena, and La Canada, CA. He is the founder of the www.KidneyStoners.org website.
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48 Responses to Can kidney stones cause kidney failure?

  1. Sheng says:

    I have 0.9cm stone on my right kidney. Im presently taking a potassium citrate with a dose of 4x a days. Can you help me what will be my chances? Thanks

  2. Pingback: Can Gestational Diabetes Cause Kidney Stones | Diabetes Reversed

  3. BJ says:

    I am dealing with kidney stone issues as well. Because I like to handle my health issues naturally, I head to the Internet for research. Two things I have found that are very helpful; 1. A YouTube channel called, A Place to Heal, is absolutely great; 2. A product called, Cleanse Drops, seems to be working fairly quickly. You can research it at http://www.cleansedrops.com. My heart goes out to you, hopefully this information will be of some help.

  4. Elizabeth Becky Young says:

    I have both kidneys full of stones. The left kidney has stones up to 9mm as of 2 yrs ago. I’m sure they’re bigger now. The right kidney has 8mm stone blocking the ureter tube. The E.R. Doc told me i need surgery, or i would lose the kidney, sooner or later. Well, im in a state (TN) that did not open up medicaid. The urologists are refusing to do surgery saying 1) i have to pay for the surgeries IN FULL before they will operate. ALL the docs in TN are now “private practices” (even the ones “associated” with the hospitals) so they can, and are, refusing to help indigent patients. this was enacted thru a law that TN passed just before the obamacare went into effect, so hospitals and docs wouldn’t get stuck taking care of broke people. -or- 2) Get medical insurance. I cant get medicaid and have ZERO income, so i cant just go out and buy insurance. I have called everywhere for help. There is no help. I cannot get anyone to do the surgery. I am in severe pain! And churches have said they dont help with issues like this. So, my only alternative is to sit here, in agony, and wait for kidney failure. What the hell am i supposed to do? I cant live in this much pain all the time! The american kidney foundation only helps people on dialysis or with kidney failure, but if i wait that long, i will have more problems and more expensive ones that i cant get help for either. There is NO EMERGENCY MEDICAID. NO EMERGENCY ANYTHING TO HELP ME. And if my problems get worse, MEDICAID WILL STILL NOT LET ME ON. i can only get medicaid if i have breast or cervical cancer. that is THE ONLY WAY ONTO MEDICAID. People are dying of cancer here (other than the breast or cervical) AND NO ONE CARES! Disability is also NOT AN OPTION. You cant get it here either. People dying of cancer on their deathbeds (and also just after they have DIED) are getting letters of denial saying their cancer isnt life threatening. I have called churches, hospitals, urologists, lions club, eagles club, elks club, etc. out of state, in state, i just cant find any help. DOES ANYONE KNOW OF WHERE I CAN GET HELP? I called healthcare.gov and got an estimate of $900 for 2 months of medical coverage, which would be just long enough to get both kidneys done (i always have to get both done. my kidneys fill up) and cram in as much healthcare in as i can, and then i can drop the insurance, as i couldnt afford to keep it anyway. This will probably balckball me from getting insurance later on if i should ever be so lucky as to be able to afford it again (im disabled, not gonna happen) but it would take care of the immediate problem. Otherwise i have to pay $10,000 up front to pay for both surgeries (this is after a 40% hosp discount). So basically, the insurance is cheaper. But the problem is i dont have 9 cents, let alone $900. Its out of my reach. And friends and family cant or wont help. I am desperate for relief! Im just about suicidal i hurt so bad! not because i want to die, i just want to stop hurting!

    • Anastazia says:

      Elizabeth ~
      I’m so sorry, first of all, for what you’re going through….I live in Canada, but as I’ve learned more & more about your healthcare system there, & what’s been going on since Obama’s ‘health’ plan was implemented, I’ve been appalled.
      Our socialized medical care has it’s benefits, but also it’s many drawbacks. I believe the lesson is, we need to do all we can to get & stay healthy, & learn to turn to & trust God for our healing needs. One of the names given to Jesus is the great Physician. I have learned to trust my life into His hands, & He has healed me of many things, including inflammatory breast cancer (the fast aggressive kind I easily could’ve died from) & He also resotred my failing kidneys. I have diabetes, which He’s helping me get free of as He’s teaching me how to reverse it naturally, & take better care of my body, His temple.
      He can give you a brand new life….hope…peace….faith to overcome…..
      …& yes, Jesus still heals today, as He did 2,000 years ago! I pray you will turn to Him, most of all for your soul’s sake, for the sake of where you will spend eternity….& that you will learn that you can trust Him with everything, every need, every hurt (& teach you to forgive those that have hurt you, as you learn what true grace is, when He forgives your sins) & I pray you’ll see that He loves you, & does NOT want you to EVER end your own life! He knows every moment of what you’re going through….He will be right there for you, if you ask Him, & allow Him to be. I pray you’ll consider this site:
      http://www.gotquestions.org/how-can-I-be-saved.html

      Also, as I pray for your healing, & pray you will turn to Him too, there’s also much you can do with diet & lifestyle that can change your situation….
      ….here is a place to start:
      https://www.google.ca/search?q=how+to+reduce+kidney+stones+naturally&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a&channel=sb&gfe_rd=cr&ei=SDWaU_2MG6LP8gf11oDYCw

      God be with you. I pray you’ll be willing to let go of the bitterness, anger, hurt & stress of how things have been so far….those things greatly contribute to not only poor health, in many ways, but also (& most importantly!) to your spiritual health!

      God be with you, & know you’re in my prayers,
      ~Anastazia~

    • Tom says:

      Elizabeth,
      I too am so sorry you are suffering so. I had my first kidney stone attack 25 years ago . It was brutally painful. Relentless pain. I got ER meds and fluids and fortunately passed that stone. Of late however, I have had three surgeries in the last three and one half years for stones. (I too live in TN… Was on CoverTn for the first two surgeries and on the new health care exchange for the third. ) Because of many many events, I have been fiscally impaired for years. Many months I had to get help as you are crying out for. I’ve been fortunate, been blessed., probably lucky too, (Funny thing about luck,it is a subset of being blessed…) So I can relate with your financial distress as well… (I ‘m still not out of the woods as I write you, may be getting in more deeply as soon as next week… Fun isn’t….) Anyway onto some help I hope…
      Had indistinct abdominal/back pain 2 weks ago. Feeling “off” the previous 3 weeks or so. since I deal with a number of chronic issues I could connect the symptoms with a cause. When sleep won’t come and meds didn’t work, ER ordered…. Bp elevated (158/95) , blood in the urine, CT followed, …ureter stone … 7mm, Right kidney twice the size of the left…. Emergency surgery done same day. (I went into the ER at 3am or so diagnosed by 6am or so, surgery by 9am that Monday morning.Stone broken up by targeted laser treatment via wire and and scoipe access thru the urethra bladder and then the ureter….. Doc told me the same thing you have been told. Without treatment I would have eventually lost my right kidney. Prior to surgery, all I was told was of the need to get that kidney working again…. Sooooo , how does this help YOU…? Not much , yet . I’m trying to get there. What I think is I had been experiencing and still am experiencing symptoms you have. So we have walked in one another’s shoes, so to speak…. So maybe what’s helped me could help you. I’ll share stuff that’s helped me and maybe it can help you…You test and see…

      It may be of some consolation to you that after this recent surgery I had renewed blockage pain after a drainage ureter stent was removed… Worse pain than before surgery. Higher Bp numbers and greater nausea… It passed but fora several hours it was rough.Used lots and lots of lemon juice and water and some cranberry juice and water. Max dose of Advil to deal with inflammation, against doc’s order’s of avoiding NSAIDS. It worked and yea I was glad… (also used compression clothing to push the blockage along, but usually that doesn’t help with stone materials. ( Though on occasion it has, Most times, no,… more pain).
      For me, I make calcium oxalate stones. These are the most common type stones. I didn’t read all your post, maybe you know what kind of stones you tend to make. Very important to know. It clues you about what the do to counteract your tendency. Oxalate stones I supplement with Magnesium citrate Potassium citrate and a multi-b vitamin. These vitamins and minerals help prevent the formation of my type stones. Diet changes and fluid hydration also vital. Stones form more readily in concentrated urine. Dilute your urine and stone creation less intense…. Now this clearly is not an exact science… I’m still learning and changing. It’s also 12:35 am and I’m bushed… I could try to give more details but this is a start. I’ll add more later, if what I’ve written helps/helped…. I too am slugging it out in various ways as well. God’s blessing to you, I hope this helps.

    • Nelson says:

      Hello Elizabeth,
      How is your condition now?
      We are a church in Canada.
      Please give an update on your condition and contact info.
      Have you had surgery yet?
      - Nelson

  5. chandrakant says:

    Hello Every one ,

    by routine check in last October 2013 I found out two 8mm kidney stone in left size , I drunk lot of water & other fluid once gain I check scan on April end 2014 & now report say i have two 10mm kidney in right side & only one of 10mm in left hand side.

    can any one believe on this report? if yes please tell me is it possible to have 10mm stone in six months?

    note: scanning was done in two seperate lab.

    regards
    chandrakant

    • stephanie says:

      I have a condition called mudullary sponge kidney and I have had at least two stones every year since I was 11yrs old.bi have had lithotripsy lazertrypsys and j stints placed u be it I have had it all at least three times!

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