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 surgical approaches. He sees patients at clinics located in Los Angeles, Pasadena, and La Canada, CA. He is the founder of the www.KidneyStoners.org website.
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96 Responses to Can kidney stones cause kidney failure?

  1. Tom says:

    I am 54 years old I have been getting calcium stones since I have been in my mid twentys. I have past hundreds of stones , except for giving me pain medicine and lithotripsy, my urologist said their nothing they can do to stop it they can’t even tell me why I get them so often, my father got them maybe 15 stones in his life time, I get so bad at times I pass one a week most the time small to medium ones but still very painful, I drink lots of water I’ve been on a low calcium diet for years. I’m in pain so often it makes for a crapy life. I have never had a kidney infection, very tired of dealing with this and trying to work in pain and on pain medicine, its getting to be to much

  2. I was told, of my 6mm right kidney stone, during a pre-operative meeting with my gastrointestinal surgeon, immediately following my procedure to repair a ruptured duodenal ulcer, in August of 2014… My General Surgeon, gave us no degree of severity, or that I should seek the assistance of a Urologist, Immediately… I was already under the care, of a Nuerosurgeon, to correct a severe case of spinal stenosis, in my cervical spine… My case required, a fusion of C1-C7, which was discovered via my MRI of my cervical spine… Upon consultations with my former PCP, and Nuerosurgeon, I was directed to proceed with my fusion surgery, (as it posed a far greater risk to my overall health… Upon the completion of my neurosurgery, I began showing symptoms of severe R. Flank pain, nausea, & inability to get comfortable, I made appt. with a Urologist, who placed a stent in my right ureter, bladder &a kidney…
    Upon several tests, including CT SCANS, IVPS, AND LASER RENAL STUDY; it was discovered, my (R) kidney, is PERMANENTLY DAMAGED, AND OPERATING AT A MAX. OF 13%… The next step, is for me to have it removed, before more damage could be done…
    I am a 49 year old male, who has endured 7 spinal surgeries, fully disabled since ’12 and literally exhausted from all of the constant medical advice… The surgeries, have left me in CONSTANT & CHRONIC PAIN, WHICH MANY OF THE SAME DR.S WHO TREATED & ADVISED ME, NOW WANT TO REFER ME TO PSYCH. DR.S FOR TREATMENT OF DEPRESSION… WHAT A MESS…!!!! Any help at all, PLEEZ…

    • Noah says:

      I’m sorry you are going through this and what you have gone through! That is horrible! I cannot believe a 6mm stone caused permanent damage to your kidneys – it’s really frightening.

      When the stone was initially discovered, did the Surgeon mention of its location? Whether or not it was obstructing urine flow or not? I find it very odd that a stone of that size can cause such severe damage. I’m no doctor, but perhaps it wasn’t the stone that caused your right kidney to malfunction. Perhaps the stone is unrelated or due to an underlying condition?

      I wish you best of luck!

    • Christine says:

      I also am sorry this has become such an issue, having experienced and long and complicated health challenge, (Lupus since 27 years old, 2 strokes due to congenital malformation in the blood vessels of the brain, 6 years of radiation, now a brain full of aneurysms) I have learned that our “medical system” is so broke, the worst thing you can do is to trust in your doctor…however there is hope. Learn all you can about your conditions, understand that the body can heal many conditions we think we can’t live with, eat healthy, stay lean, and exercise as much as possible. Your body was meant to move, not be stagnant. When we hurt, we slow down, and this exacerbates the issues.
      I have lived with constant chronic pain for more than 35 years now, and I do use medications, but I am lucky enough to have a doctor that listens, knows I am not in favor of over medicating, and believes I know my body best. It is a long journey back from where you are today, (I was there 25 years) but you CAN learn what your body needs to function at it’s best.
      Today, at 64, I run my small ranch with 2 horses (they need exercise too) 2 dogs, (they need exercise also) and all that comes with the rural lifestyle. My animals needs are what keeps me on track, it may be different for you but if you want to, you can find something that will drive you to a better life also. Best of luck!

  3. Gomwalk Henry says:

    I have excreted 2 stones. 1 in December 2014 and October, 2015.
    I now feel a burning pain on my right side.
    Doctors don’t seem to have anything for my relief. I don’t know what to do. The pain is much.
    Can someone advice please.

  4. Noah says:

    I was diagnosed with kidney stones in August of this year. I originally had blood in my urine, which prompted me to go the ER. There I was arranged to meet with a Urologist who had me go through an ultrasound and cystoscopy. Both came out fine. I then had a CT Scan which revealed the stones – and the culprit for the blood (according to the Urologist).

    I’ve had lithotripsy to remove one large stone my right kidney (14mm!) but the 7mm stone is still there, as well as a bunch of smaller ones in my left (1mm-3mm). I’ve been experiencing some bubbles in my urine which have been worrying me. Before my lithotripsy, I did a urine test, which showed protein in my urine. I didn’t think too much about it because the doctor didn’t say anything about it.

    Well, even though the gross hematuria is gone, I’m noticing I still get the bubbles in my urine. I’m worried that the remaining stones are causing damage to my kidneys – or the previous large one caused some damage. I hope to see my family doctor in the next few days to get a urine test to see if these floating tiny bubbles are protein, and if so, how much.

    Worried!

  5. Habib says:

    I have been suffering 18mm stone in my right kidney and 6mm stone in my left kidney for last 9 years. I regularly using homeopathic medicine which give me relief for time being. Now I,m looking towards a suitable treatment which can save my life and my kidney.

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  7. sandeep vashisht says:

    i have a stone 17.5 mm in my right kidney from last 5 years .
    is it dangerous for me?
    is kidney stones cause kidney failure?
    my doctor advised me ESWL and he done it on me 2 time but i feel no relief so can you tell me some other treatment.

  8. Nicole says:

    Hi Amy! I feel so bad for you. I can relate somewhat…I’m in a lot of pain right now and hence surfing the net for answers. I see my Urologist on Thursday. I have had 1 lazer surgery and either 3 or 4 lithotripsy procedures now. I haven’t ever experienced this type of pain I’m in now though. My family Doctor is treating me for a Urinary Tract Infection. I was at the hospital 2 weeks ago and after a CT scan, all they could tell me was that my left kidney was full of stones and sent me home with a prescription for OxyContin, so what’s the point of going to the hospital when they don’t help you find a solution for your pain? Everyday is worse than the next and I can’t wait til this Thursday when I see my Specialist.

  9. Amy says:

    I had my first kidney stone in 2005. Doc said it was a result of having leukemia and the chemotherapy which causes cell death. So three lithotripsy procedures later…fast forward to 2015. June I had kidney pain again, had a CT Scan and found a 12mm stone. 4th lithotripsy, and this recovery was not easy not was very painful. Spent the next two months having gallbladder tests run because I was still in severe pain. Low and behold the stone was still in my kidney. Had a PERC procedure to remove the stone….turned out all the fragments had formed into a stone again as the anatomy of my kidney did not let the fragments pass. Got all the stones out this time 9/15/15….and here I am again with the same pain. Doc says kidneys don’t hurt unless the stone is blocking. I say that’s crap. Anyway I am 5 weeks post PERC procedure and and have formed another large stone, just don’t think I can do another lithotrios or PERC. Can’t stop my chemotherapy. I’m basically up a river without a paddle. Ugh.

    • Dawn says:

      I feel you Amy!!! I am in a similar boat. I have been dealing with stones and kidney infections since 1993 :(
      I have had perc, lithotripsy and nephrostomy procedures. I will never do another perc ever, that was the worst experience of my entire life.
      I currently have 3 stones, all over 8mm. I cannot fathom going through any of the procedures ever again. I basically looked up this website just because I was wondering what is the worst that can happen if I just don’t do anything. Since my very first hospitalization, which was a kidney infection in 1993 for 5 days, I have been begging the doctors to just take it out. It’s always my left kidney, so I’d still have one. Obviously, that isn’t going to happen. I just don’t know what I am going to do next. The whole “if a stone isn’t obstructing then you don’t feel pain” thing is big load of bull. I get that they have so far not found nerve receptors for pain located inside the kidney, but when one kidney has been damaged severely enough, it is scarred and swollen and sure does hurt especially during key points of a woman’s cycle.

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