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.


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 website.
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140 Responses to Can kidney stones cause kidney failure?

  1. Troy says:

    So it seems this has possibly happened to me as I go in to find out today. I developed stone 8mm first one ever, did surgery after putting it off a few months. But started to have blood and protein in urine and did the laser litho and passed a couple small stones afterwards. 5 mos later, had blood again went back for x ray and founs another 5mm stone. Dr said lets watch it. 2 mos later have blood again go in and they want to schedule scope and contrast MRI. Blood was in mid Dec 16, I declined contrast dye and the nurse said to come in for your scope in 3 weeks and do that and discuss with DR. So Dr orders without contrast Dye 3 more weeks for apt and results. 6mm in ureterer but no swelling of Kidney mentioned. He asked how long and I had no idea. Does 1 week x ray and no movement. So schedule surgery for about 10 days out. By this time it is early March and stone may have been there for 3 mos by that time. He said is was basically wedged in side of ureterer, afterwards had stent for 1 to 2 weeks along with xray, which was awful but after stent removed much relief, no blood and better urine flow, nothing mentioned about X ray of kidney, no issues other than a couple stone fragments I should pass. One month later do my 24 hour urine test to see what is causing stones and go in for X ray and results today, however the day after xray which was yesterday I receive call from radiology about coming in for an ultrasound. Had no idea they were ordering it and the x ray guy took far more x rays than normal or other times. So figured given that in the last week I just developed many symptoms of pain in Kidney, low urine flow and amount, constant need to urinate, bubbles in urine/ protein more than before that the kidney has began to fail. Pulse and blood pressure have been up also. Also having pain now and then in other kidney also. Hoping for a miracle. 47 yrs old with 2 kids at home and wife. Didn’t hardly sleep last night, took day off, have to work tomorrow but not sure I will be able to after the news from the Dr and wife is away on work until tomorrow so no support here today or tonight. If it has failed or is damaged, hopefully other one is good and does not deteriorate from Kidney disease or anything else. Praying for the best as my family needs me and I want to see my children grow.

  2. DAve richards says:

    Just had lithotripsy on my right kidney it had a 5mm stone. HAve to go back and have the same procedure done on left kidney which has a 7mm stone in it. Since both kidneys are producing stones, do I run the risk of kidney damage or failure?

  3. Pingback: Can You Get Kidney Stones In Your Gallbladder | How to Cure Gallbladder Stone

  4. victor cajag says:

    we have a herbal remedy how to get it off your kidney stone with out udergoing a operation

  5. Angela Suratt says:

    I had a 4.1cm stone in my left kidney and a 3cm stone in my right. I began treatment 1yr and 2mo ago. 6 litho.sound wave procedures and 3 lazer, basket procedures on my left we think its finally clear. I go tomorrow for my 2nd lazer basket on right side. Im concerned all these procedures accompanied by the length of time will do more damage than if they had cut them out. What can i do?

  6. Dave qiirt says:

    I have been diagnosed of a large stone blocking my kidney took a p.e.t.ct 2 months ago took this long for doc to get results he had to call after I called him after 2 month wait they failed Iowa send test to dr who requested test could this possibly caused damage to my kidney

  7. Cheryl Johnson says:

    I had a 3 cm struvite stone in my left kidney. Now a year after its renoval and the still constant infections and stones, I am having my left kidney removed. My right functions perfectly. My urologist said instead of running 50/50 they are running 85/16 so its like I have one kidney anyways right now.

  8. Rajeshwari Ohal says:

    For 20years I am suffering from kidney stones which are of calcium oxylate can in future they cause kidney failure

  9. Pathan Romana says:

    Hii i have 24 mm stone in my left kidney and the right is invisible

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