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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126 Responses to Can kidney stones cause kidney failure?

  1. Lann Donald says:

    This is my first time that I have 2 to 3 2.6mm stones both in my kidneys I have take medicine’s for one month but I’ve face problem in my right kidney it pains a lot in my back abdomen shall it gone and passed out or have to go for surgery??..

  2. Shadman says:

    Hi sir… I am 21… I had severe pain (which lasted about 10mins) in my right kidneys around 3 months ago. I did all sorts of tests (urine RE etc) and ultrasound. Nothing serious showed up. A few days back, I had the same pain again. Need some help as what should I do next? And is this a serious problem?

  3. Donnie Sarden says:

    Hi
    I had secere pain in my sides went to hospital they admitted me stayed 3 days came home. Ct scan vaginal ultrasound and outside also. 2 cyst on ovary pressing against uterus it was pressing on ureter causing back flow into kidney. They operated after mri and took ovary out. I am still having problems with kidneys cant sleep pain in both sides severly. Kidneys are swollen. Am I going have kidney failure or kidney damage. This has been going on for 8 weeks or more. Pain is unbearable sometimes.

  4. Karen Marino says:

    I have a 9mm Kidney stone in my left kidney, the first time I was told this was at least 11 years ago so it could be bigger now. I’m reminded of it everytime I get a CT scan, they mention it, but not one of them has suggested I have it looked at or removed. They just tell me I have it and that’s it. I also have high blood pressure, should I be concerned?

    • KW says:

      Yes. That is large! Mine is close to 2 cm and caused a blockage and I need surgery. I keep getting infections. I had to go to the DR and get a stent put in. It is causing me so many problems. Get to the urologist ASAP.

    • KW says:

      I apologize. Yours isn’t a large stone yet but you still should have it checked out.

    • Toni says:

      All kidney stones should not be left as they have the risk of growing. If the stone is in the lower pole of the kidney, it tends to stay where it is and grow in size. My advice is to ask your doctor to send you to see a consultant in your local urology department who can help you further.

  5. Rachit says:

    Hi,
    I an having a 4.6 mm stone at the junction of the Ureter and the Bladder (Uretrovesical Junction). I sometimes have a problem in urinating and a slight amount of pain, once or twice a week.
    What can be done about it? Shall I wait it to pass through the urine or should I go for Uretroscopic surgery?
    Thanks.

    • KW says:

      It may not pass. Sounds like a blockage. Urinary retention can be life threatening. That is a very large stone. You really should go to the urologist right away.

  6. Dreck Musvamhiri says:

    I have got a kidney stone in right kidney 0,73cm, it is not in the uterus but it’s inside the kidney it’s painful, fever, back ache, right side abdomen ache. So which suitable method can be used to remove that stone, l can’t sleep with that right side

  7. Brittnee says:

    I had kidney stones at the time January of 2015 my body tried to pass a 13mm stone and had to have emergency surgery they placed a stent and passed the other ones and Sept of 2015 I found out I have bilateral stones ranging from 2-4mm and the largest was a 6 on the left side, here I am a year later and I have only passed one stone since last September and am worried because I’ve been having a lot of pain on my right side and discomfort and sometimes radiates to my shoulder and chest it gets so bad, can someone please give me advice on this

  8. rimpy says:

    last week my father had a bad pain in kidney. we took him in near hospital. doctor took a test ct scan and said that his left kidney has 4to5 stone with 27mm, 22mm 18mm,3mm, 2.5mm, 2mm respectivily. doctor gave his opinion that there is no need to remove these stones because this kidney has already damage.but i have aquestion that these stones can create a magger problem in future or not…

    • Toni says:

      Why not go back and ask the doctor or hospital for further information. Is the doctor saying the kidney is dead?not working anymore? Is it a case of not removing the stones due to your dads age and the surgery thats involved? These are questions that i think anyone would want to know.

  9. Last Apr 6, 2016 I was in a lot of pain so I went to the hospital. CT Scan showed I had a 3 mm kidney stone. I’ve been in pain for three days (apr 6- 8) until the urologist prescribed potassium citrate (Tascit) for 2 weeks (mainly because the kidney stone is quite small). Just today (April 18) after 9 days with continuous medications and more than 2 liters a day, the stone has finally passed.

  10. Monika says:

    My sister had kidney stone which is of 28mm and doctor says that .. Stone is come into contact with nerve and respectivly cause damage to nerve through which she is suffering from infection in blood which is of 13600 and due to infection she is sufferng from fever, headache and sometime vomitings olso.. Will she should undergo an operation as soon as possible and does it cause kidney failure..?? Plz reply…

  11. Theresa says:

    My son who has HIV and a MAC infection had large stone in each kidney. Stints were put in but the stone were not removed. Now He has tubes in both kidneys sticking out of his back. These tubes have been there for 3 to 4 weeks now. I fear he is in kidney failure .

  12. sulbha says:

    I have bilateral multiple renal calculi from 2013 .my age 23yrs .4 lithotripsy for right kidney in 2013 size of stones 15mm,10mm and 4 stones of 8mm.now last month lithotripsy of left kidney. of stones size 14mm,10mm ,8mm now more pain in left kidney also more blood in d urine some time fever .before 8 days ago urine examination done .Dr giving antibiotic for infection. now more coughing in left kidney DJ stent is present I m suffering more pain during coughing. rt kidney is alright. only pain in left kidney.also more pain for urination

  13. Sandeep singh says:

    Hello dr.
    My name is sandeep singh chemistry lecturer.
    I hav stone problem below 6mm(multiple) from last 5 years.
    My dr. Advise me not take tension its normal. But im satisfied.
    Pain is silent sometime.
    Pls suggest me what to do?

  14. Stephenie says:

    Hi, I am 49 years old. My name is Stephenie. Last weekend on Sat I was in severe pain on my right side. It feels like a sharp jabbing pain under my right rib cage to my back. But, finally on Tuesday I couldn’t take the pain any more and all of my glands in my right side were swollen, including my throat, so i went to the ER. My blood pressure was 250/167. I was admitted. They hooked me up to a EKG and did a X-Ray, Sonogram, and VQ scan of my lungs. They couldn’t figure out the pain in my right side. But, they told me that my right kidney isn’t functioning and that I have a stone in my left kidney. I can’t understand why I still get pain periodically in my right side, and nauseousness. I wish they can figure out what is wrong.

  15. Nirmal Tailor says:

    I’m Nirmal From India, I have a kidney stone since 2003 and I got operated for Kidney stone once and appendix as well, but still have kidney stone and its paining some of the day.

    I just want to know that is there any permanent solution for kidney stone?
    Is there any harm on kidney because of kidney stone?

    Kindly suggest something what to do.

  16. 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

    • Jennifer says:

      I have had stones since I was 20. The old method used to be a low calcium diet. Many doctors don’t do that any more. They found it was causing brittle bone issues. I got prescribed a low does of hydrochlorothiazide recently and it has solved many of my issues. My urologist also recommended reducing my salt and protein intake to reduce the acidity in the urine. Acidic urine increases the stone formation.

    • Lani says:

      If u drink Tea. Stop. If u eat ice cream Stop…. I did. Stone free for 14 yrs. Knock on wood. Thank u Jesus. Good luck

    • Eva Escobar says:

      Look up chanca pierda

    • Paula says:

      I understand this too well. I was getting calcium kidney stones constantly. Once I started drinking purified water w no minerals they stopped. Not sure what type of stones you get. Maybe it will help. Best of luck.

  17. 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!

  18. 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.

  19. 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!

    • Cheryl says:

      Get the 7mm stone out. If you leave it there it will harm the kidney. I had a ‘silent’ 7mm stone for over 15 years. My right kidney is now functioning at only 11%. Luckily, my left kidney is perfect and compensating for the right. When my urologist told me about my right kidney, I cried on the way home. I had gone through 4 procedures to get ride of the stone. It would not break up. If your current doctor is not doing anything, keep going to a urologist who will treat it. You can’t leave it in there. Then make sure they follow up to check for scar tissue in the ureter to make sure it does not cause blockage from the kidney to the bladder. I had total blockage. Luckily my urologist decided to do follow up tests since I had 4 surfers 2 weeks apart until she removed all the pieces she possibly could once it broke up. So that meant a fifth procedure. Now I am facing possibly another because more scar tissue formed, but not totally blocking. So don’t delay. And do your own research. They don’t think to tell you all the details so you can ask specific questions.

  20. 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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  22. 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.

  23. 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.

  24. 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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