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.
This entry was posted in Information. Bookmark the permalink.

38 Responses to Can kidney stones cause kidney failure?

  1. pat says:

    I am a 67 year old male. I had my first kidney stone at 34, and the pain was horrible.
    As I arrived at the ER the pain quit completely and I passed it two days later.
    I have had hundreds of stones since, all have been small to very small and for some reason very few have caused the level of pain a few have. two have been awful and took nearly two months to travel to the bladder. both were just a bit smaller than the eraser on a wooden pencil. I have had Litho sound treatment 4 times. I could tell you stories about my experiences with Urologists, some of which were so comical noone
    would believe. I have 14 in my little jar that have passed since January 1st, 3 months.

  2. Fred says:

    I have kidney stones cause is Sarcoidosis. It causes hypercalcemia which lead to the stones. I am going to try to eat only organic foods cut out sugar. I will let you know if it helps. Oh yea I have stated drinking water with fresh lemons half a lemon per quart it helps with urination and I don’t need flowmax pills which have side effects I don’t like.

  3. Charlene Crosthwaite says:

    Do the urologists remove a stent with several 8-11 millimeter stones still in the kidney?
    Had blasting done the 15th of July and first week passed a lot of small pieces and a few bigger ones. Had already passed 5 stones before treatment, but a 1.7 centimeter blocked the tube and kidney was bleeding.
    Since seeing doctor last time very little has passed and have had pain (not nearly as
    bad as before) in my left side.
    Stent is a bit uncomfortable, but not extremely painful.
    How long can a stent be left in place?
    Mine has been in since the 21st of June 2013.

    • Eve says:

      I suffer from kidney stones and have been for years. I have Crohn’s Disease and I was told this is why I am making them. I had a 15mm stone removed in May of this year and just had more stones removed Aug 13th which were 9 plus in mm. This time, my doctor is leaving the stent in for 2 weeks before removing it. Usually it is a week or week and a half.
      Something I would like to share here is that a cousin of mine shared a product he is taking and still continues to take which helps him pass the stones without incident or surgery requirements for the past 15 years! I tried it and it worked for me too! I ran out of it which led to the two past surgeries but I will be purchasing more this week! It is called: Chanca Piedra and is only available at certain reputable Health Food Stores! It has a blue label. It does not prevent you from making them but it does help you pass them by breaking down the stones so you can pass them without pain. You can learn more about this product online and contact Ambrosia Health Stores to learn more. Good luck to all!

  4. Rachael Dehart says:

    I had went to the ER because I was having a lot of pain. The doctor decided to do some blood work and said I had a kidney stone in my left kidney but it was a non obstructed one. Then he said only 2/3 of my kidneys were doing what they are supposed to do. He thought maybe it was from the stone. What does this mean?

  5. Carol of the Stones says:

    In January I had a 13×5 mm stone taken care of by lithotripsy that was in my kidney and causing significant pain. I successfully passed a 3mm stone and some sand within a few days of the lithotripsy. Calcium oxalate.

    Now in June, I am experiencing kidney and groin pain that is very similar to the pain I had with the large stone. I am assuming this is another kidney stone. I am pretty sure it has left my kidney and is stuck somewhere. Ouch. I have an appointment with the urologist in a few days to sort it out. The KUB two weeks after the lithotripsy showed no stones in my kidney. I had a stone pass 20 years ago but otherwise have not had anymore until January.

    My question is about whether I can grow another kidney stone that fast (5 or 6 months) or could this possibly be a piece of sand left behind from the lithotripsy that has decided to venture out 5 months later?

    • jeannette Solomon says:

      4 weeks ago I had lithotripsy performed external. The stone was broken into a number of smaller stones. This past weekend another 7 millimeter stone appeared and I was back in ER and OR for stint and internal lithotripsy. The stint was removed 3 days after the procedure and the broken stones passed. I am presently taking Vesipur. I plan on taking it for the next 3 months to help break down any stones. There is also a tea, dandelion, parsley, lemon, ginger and honey that helps with passing stones and the pain stones cause. Good luck. This is not pleasant. I am also drinking distilled water ONLY> j

  6. DANIEL AUBE says:

    I’m 30 I’ve had kidney stones since age 14 . I’ve had 13 lithrotipsy and two basket surgerys.Now I have a stag horn that they want to do open surgery now.SCARY!!! I’ve had my appendex burst, I have intestinal problems, colitis diverticulitosis meckel’s diverticulum . I haven’t been able to work for over for years do to pain and always in the restroom. I can’t get any help except my wife that works extra hard to pay for my surgerys. Its hard on the kids .they’ve denied ssi 3 times . I don’t know what else to do.

    • Zareen says:

      Buy horse gram from any Indian grocery store and soak 50 grams of in water for 10 hrs and drink that water. Drink every morning and evening (note soak 50 grams or more for each time) . This will help

    • sandy forth says:

      im going through the same and unless one has felt the pain of it all they will never understand it all and its so painful.

  7. rajesh gurung says:

    I m suffering frm kidney stone , my two stone is passed away, but still there is two more stone in my left kidney ,m drrinking lots of water everyday but its not going now wat to do plz send me some sugestion in my email .thnk u

  8. Suz says:

    I am 45 yr old female, and have had stones for 20 years. There was 10 yrs of no stones passing, but this past year they are passing often again. I have painfully passed at least 25, and have no idea how many passed silently, who knows? In any case, with xrays over the years, I have had an average of 5-7 stones in both kidneys at any given time.
    1 year ago, I passed a 4mm during a painful 8 hour ordeal. 3 months ago, I passed 2 stones within the same amount of days, 1-2 hours each stone.
    The issue is this- the norm for me is I pass a stone, I have blood in urine the day before and the day after. Since the 2 stone/2day episode, I have had continous bleeding. It has been going on for 3 months.
    i found a urologist, and after ct scan found multiple stones in both kidneys, one stone at 1cm, mudulla in one kidney larger than the norm. No cysts or other abnormalites. Still waiting for 24 hour urine results. Bloodwork fine, bladder scope fine.
    So- where is the blood coming from. Blood in urine for past 3 months varies from exteme to microscopic daily.
    Urologust wants to do litho on 1cm stone. I am worried that recovery will be difficult and long if stone is only broken down to 2-5mm, and that the other 5-7 stone will want to pass too. As i understand it, he wants to break down only the 1cm stone. I cannot be out of comission for weeks after the litho! I have reached my max. I have reached the point that if stones take longer than an hour to pass, I will lose my mind. Its been going on so long, and I am frustrated and worried now.
    I think I found a good, proactive doctor, but I am also worried my kidneys are damaged now from having docs who were not proactive all these years.
    The new doc wants to put me on medicine and vitamin treatment once the stone analysis is complete and I will be happybwith that.
    Any advice or opinion if blood in urine is now damage, if I should do the litho, etc.

    thanks.

    • Hanna says:

      Please research Loin Pain Hematuria Syndrome (LPHS). This is a rare kidney disease that produces blood in the urine and results in pain (with/without stones present). Many Urologists and even Nephrologists are not familiar with it (because it is considered to be rare) but there are lists of specialists who know what to look for and with a little bit of research you should be able to find one. There are also support groups on FB. I hope this helps you to find the answers you need.

  9. Sitaram Thakur says:

    I have 6.5 MM stone in right kidney of lower pole. Please let me know which hospital providing the Ureteroscopy system. I want to removed it without any surgery.

    • Dr. Mike Nguyen says:

      We recommend that you check with your local hospital to see whether ureteroscopy is available in your area.

  10. raju ghimire says:

    I am suffering through 6.5 MM stone. I want to remove it by Ureteroscopy system. Please could you tell me is this service is available in India; let me know name of hospital.

  11. sidram says:

    My father 40yrs old is suffering from kidneystone from three years does it cause any effect on kidney.he has stones in left renal.

  12. Tammy Perez says:

    3weeks ago I found out I had a 8mm kidney stone, 2 weeks ago I had the shock treatment that only broke it down to a 6mm square now hey want to go in an remove it an put a stent in for 5 days. I have no insurance an I have to pay out of pocket, how long can I go with this stone before it does damage? I’ve had it for a bout 3 months before the first treatment.

  13. Peggy says:

    Surgery after passing 6 large kidney stones verified perment damage to my left kidney. The surgen clamped the utter off going to the bladder, to prevent back of urine into the damaged kidney and told me the kidney would die and need removed. ,but insted of removing it then – he monotered it doing renal scans. I had to move, leaving the damaged kidney inside of me. Dr here refuses to refer me to a urologist. She states she IS NOT a urologist, and does not know what to do. Can this damaged kidney kill me. The diaganoses was 4 years ago. I have severe pain in my back when bending over, and I am scared. Can I live with a damaged kidney left inside of me?

    • Nouman says:

      No, Lot of people live with one kidney. You should go to urologist for further treatment of damaged kidney.

  14. Luis Escajeda Pineda says:

    my loved 14 year old son has a very big silent stone in the ureter we thought he was alright , but he started to het thinner and thinner and thinnmer finnaly we found the stone but it is too late dr says the kidney needs to be removed am devastated
    If the kidney has been damaged can it recover?

  15. Austin says:

    Is it okey with any weight gainers or any supplement facts after the treatment of kidneystone?I used to consume these things before and now I want to continue that stuff.can I continue or I should stop for to avoid another chances of kidneystone in the future?????

  16. Magdalena says:

    Hi , I have in my both kidney many stones the larges one is 3.8cm in left kidney and 3.4 cm in right kidney , I have no pain at all. My gfr is 47 (mdrd) dr. Said is low cos of infection (bacteria Escherichia coli) now I’m on antibiotic … On ultrasound my kidney are right size , shape and there is any dialeted seen -dr.said there is everything good , just the large stone is bad… And I have to remove ASAP … Cos might cause kidney failure , is that true ? My kidney can stop working ?or stone have to blockade urine flow to that happen ? How can I have it remove ? Thank you

    • toni corbin says:

      my son is recovering in hospital now after kidney stone removal of large one blocking ureter to left kidney,which can cause kidney damage ,if left there too long and ultimately possible kidney stop working….it s usually outpatient but he s paralyzed and has greater risk for complications……….they went through his penis with scope,broke it up with laser and used a basket/claw like device to retrieve bigger pieces…dr put in stent to keep passage enlarged and open so pieces can flush out…stent will be removed in drs office in one week.

  17. amelia says:

    I just found out I might have kidney stones and am scared.

  18. asma says:

    I have kidney stone for 6 years, it is 10 mm, it does not have any pain, now i am going to do lithotripsy but i am so worried, can i leave my stone for longer period of time or i need treatment?

    • Amy says:

      I have had many stones in my life time. Just had one lasered today. The one thing that I wish I could go back to is the day that I agreed to let them do lipotripsy INSIDE the kidney. This was done about 5 years ago. When they did this it broke the stone up, but , sent gains of “seeds” through out my kidney. Which actually created many, many stones in the kidney over 5-6 years from one stone.
      My suggestion to you is to speak at length with your doctor and look at all options.
      A 10mm is not one that will pass, so something will have to be done.
      I hope that you will go through whatever procedure you choose and have a great outcome in the end and the future.

  19. Jill says:

    Greetings. I have a 2mm stone in the middle calyx of my kidney.
    it’s been 2-1/2 months I am taking Potassium citrate and Rowatinex.
    The stone does not cause fever, nausea and there are times I cannot feel the pain when I am in motion. But there are times when I walk, I can feel a little pain in my left side.

    My doctor said it will pass but I am worried why until now my kidney stone does not pass and base on ct scan there is no obstruction from my kidney, ureter.

    I also drink plenty of water, lemon with olive oil.

    Please help me out how to pass or dissolve my kidney stone.

    Thank you.

    • KidneyStoners.org says:

      Small stones such as your 2mm stone that are not actively passing down the ureter can stay in place for long periods of time. In one study, only about 1 in 5 stones of that size will pass or require treatment over a period of five years.

      Most stones cannot be dissolved (the exception being uric acid stones, which account for about 5-10% of all stones). There isn’t anything proven that you can do to make your small stone move out of your kidney faster if it is happily sitting at the end of a calyx. Once a stone starts passing down the ureter however, some medications can make that process faster.

      There is a lot of debate about whether a stone that small (2mm) can cause significant symptoms. Traditional thinking is that stones cause pain when they cause blockage and not when they are just sitting in the kidney. In some cases, run-of-the-mill back pain can be mis-interpreted as being caused by a small stone by both patients and doctors. That said, there are definitely some patients that do have discomfort from a small non-obstructing stone for unclear reasons.

  20. nimfa says:

    i’ve undergone an operation due to impacted kidney stone.my doctor told me that my right kidney might have the possibility not to function normally because it’s almost damaged due some part were already thin because of the obstructions. will i still have a normal life after this?

  21. Shaks says:

    I too have stones in both the kidneys, I passed one stone through urine, it was crystal type had very sharp edges that stone was very painful but lucky it’s gone. Now after 2 months again there is a stone in my both kidneys. I am not taking any medicine because the pain is very dull and sometimes there is no pain at all. So I just wanted to ask can kidney failure occur suddenly? even if occurs suddenly how much time we get to save the life by kidney transplant?

    • Matt says:

      allopurinol. Someone suggested it to me and haven’t had a stone or gout since

      • Charlene Crosthwaite says:

        Allopurinol is great for gout, but make sure your doctor does blood tests every so many months because the allopurinol was
        affecting my liver and I had to be taken off of it. I can have it for emergency use only, when I feel a gout attact coming on.
        Gout is extremely painful too.

  22. Deb says:

    My Husband has been suffering with kidney stones for over 10 years.
    On average he passes (that he knows of) a stone every 2-3 months.
    He is under a consultant and has had various scans.
    He has a 6-7mm stone (uric) in the lower pole of his left kidney. It has been there for
    2 years. It has had it ‘blasted’ twice to no avail.
    He also has some renal cysts – benign.
    From this he needs only see consultant in 6 mths.
    However, he does not go a week without pain and has night sweats 2-3 times per week.
    The pain in his side often causes restless nights.
    What can we do to get through to our consultant that something must be done.
    How much longer can the damage caused by the stones be a significant problem.
    Many Thanks.

    • KidneyStoners.org says:

      A stone of that size not causing obstruction is unlikely to cause kidney damage. Kidney damage from stones usually occurs from repeated or long episodes of blockage of the ureter or from infection related problems. Your husband’s stone can however cause discomfort and treating it may help. We stress “may” because for stones that are not actively causing obstruction, treatment is not guaranteed to make the pain go away.

  23. mike says:

    my husband has a history of kidney stones he often has severe back pain and leg pain i argue with him to go to the doctor in the last 7 years he has 4 stones that he passed out and for the last couple days he hasnt been going to work due to felling fatigue and nausea i dont what to do his mother passed away from doing dialasis and i dont want to experience my husband going through the same it is heart breaking I love him so much he tells me the pain from 1 to 10 is always 11 . i need help

  24. Cheryl says:

    I have a lifetime history of stones, including a “staghorn” 2 years ago, and from stent placement last week – “over 100 tiny stones”, which my doc says shows that urocit-k is working, just need to increase my dosage. My question is, are all “staghorns” considered struvite? My previous history is with oxalate stones (including current). Does this mean I’ve had two different types of stones?

    • Dr. Mike Nguyen says:

      A recent article published in December of 2011 sheds light on your question. Researchers examined the chemical composition of 52 staghorn kidney stones. They found that only 44% of the staghorn stones were infection related (struvite) while the rest were what they called “metabolic”. Among the metabolic stones,the most common type was calcium phosphate (55%), followed by uric acid (21%), calcium oxalate (14%) and cystine (10%).

      It appears that the assumption that staghorn stones are almost always infection related may no longer be correct.

      Viprakasit DP, Sawyer MD, Herrell SD, Miller NL. “Changing composition of staghorn calculi”. Journal of Urology. 2011.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>