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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89 Responses to Can kidney stones cause kidney failure?

  1. 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.

  2. Diabetes is basically very chronic in nature and unfortunately there’s no proper cure for
    it. The signs and signs and symptoms of diabetes develop slowly and are very hard
    to detect inside early stages, and also the later stages might
    be really very hard for that sufferer and can cause development of many complications at the same time.

  3. 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.

  4. 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.

  5. 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.

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