What causes kidney stones? The short answer
Kidney stones form when your urine carries more dissolved minerals than its water can hold. The main stone-forming minerals are calcium, oxalate and phosphorus. They are normally in urine and harmless at low levels.2 When there are too many of these particles and too little liquid, they start to stick together as crystals, and over months or years the crystals can grow into a stone.9
So anything that means less water or more minerals in urine raises the risk. Not drinking enough is one of the most common. Others are sweating a lot, very salty food, lots of animal protein, a family history and some medical conditions.1710 About 1 in 10 people will have a kidney stone at some point in their life.8
This page explains how the body works; it isn't medical advice.
What are kidney stones?
A kidney stone is a hard, pebble-like piece of material that forms in one or both kidneys. Most are yellow or brown, and they can be smooth or jagged. They can be as small as a grain of sand or as large as a pea, and very rarely as big as a golf ball.1 Doctors call a kidney stone a renal calculus or nephrolith.1
To see where they come from, start with the kidneys themselves. You have two bean-shaped kidneys, each about the size of a fist, just below your ribs on either side of your spine. Together they filter about half a cup of blood every minute. They pull out waste, extra water and extra minerals, and that mix becomes urine.5 Each day your kidneys filter about 150 quarts of blood, but only 1 to 2 quarts end up as urine. Urine then flows down two thin muscular tubes called ureters into the bladder.514 Keeping the right balance of water and minerals is part of your body's homeostasis.
How do kidney stones form?
Think of sweet tea. Stir a spoonful of sugar into a glass of water and it disappears: it has dissolved. Keep adding sugar and at some point the water can't hold any more. Chemists call that point saturated. Any extra sugar stays on the bottom as crystals. If a liquid ends up holding even more than it normally can, it's supersaturated, and the extra is ready to come out as a solid.12
Urine works the same way. It's water with minerals, acids and salts dissolved in it.9 When it carries more calcium and oxalate than its water can keep dissolved, the extra comes out as tiny crystals. The crystals stick together and build up layer on layer. That's a kidney stone.910 It's the same idea as other crystals in nature, like the ice crystals in snowflakes or the carbon crystals in diamonds, only much smaller and messier.
Your body also has helpers that slow this down. Citrate, found in citrus drinks like lemonade and orange juice, can stop crystals from turning into stones.4
What are kidney stones made of?
How do people get kidney stones? The main risk factors
- Not drinking enough. This is the big one. With less water, urine is more concentrated, so minerals cluster together more easily.107 Drinking enough liquid, mainly water, is the most important thing you can do to prevent stones.3
- Heat and sweat. Water lost as sweat, whether from summer heat, saunas or hard exercise, leaves more concentrated urine.8 Studies link hot days to more kidney stone episodes.13
- Salty food. The chance of stones goes up when you eat more sodium.3 Too much salt or sugar can make your body send more calcium into urine.7
- Lots of animal protein. Plenty of meat, eggs or fish can make urine more acidic and raise uric acid.17
- Some high-oxalate foods, for people who have already had calcium oxalate stones: nuts, peanuts, rhubarb, spinach and wheat bran.3 For most people, cutting out fruit and vegetables isn't the answer, because plant foods help prevent stones.8
- Family history. Stones run in families, often because many small gene differences combine with diet and drinking habits.10 Having had one stone also makes another more likely.1
- Some health conditions and medicines, such as obesity, gout, type 2 diabetes, bowel conditions, repeated urinary tract infections, overactive parathyroid glands and some long-term medicines.110
What causes kidney stones in men?
Men get kidney stones more often than women. In the US, about 11 percent of men will have a stone at least once in their life, compared with about 6 percent of women.1 Stones are most common in men in their 30s and 40s.9 The causes are the same as for everyone: too little water, too much salt or animal protein, heat, family history and some medical conditions. Scientists are still working out exactly why men are affected more often.13
What causes kidney stones in women?
Women get kidney stones from the same causes as men. The difference is how often. Stones used to be seen as mainly a men's problem, but the gap has narrowed: US surveys show the rate in men has stayed about the same, while the rate in women has risen (from about 6.5 to 9.4 percent in one national survey series).13 So yes, women can and do get kidney stones.
What happens when a kidney stone moves?
A stone can sit in the kidney without causing any trouble. Problems start when it moves into the ureter. A small stone may pass all the way through with little or no pain. A bigger one can get stuck, block the flow of urine and cause severe pain or bleeding.1 Around 80 percent of stones pass on their own, and a stone smaller than 4 millimetres may pass within one to two weeks.9
When a stone is too big, doctors have ways to help. One is shock wave lithotripsy, which sends shock waves from outside the body to break the stone into small pieces that can pass. Other methods use a thin scope to reach and remove the stone.4
Severe pain, a fever, or blood in urine means see a doctor right away.12 Treated in time, kidney stones rarely cause lasting damage.1
How can you prevent kidney stones?
- Drink enough, mostly water. Many health professionals suggest six to eight 8-ounce glasses a day for adults (unless a doctor says otherwise), and more in hot weather or when you sweat.34 A simple check: light yellow or clear urine usually means you're drinking enough.11
- Go easy on salt. Lots of sodium hides in canned, packaged and fast foods.3
- Keep calcium from food. It helps rather than harms (see below).3
- Eat plenty of fruit and vegetables. People who eat more plant foods tend to get fewer stones.8
People who have had a stone can get a plan from their doctor based on the type of stone they had.4
Common misconceptions
"Eating calcium causes stones." Calcium from food doesn't raise your chance of calcium oxalate stones. In the right amounts, it binds to oxalate in your gut so less of it reaches your kidneys.
13 High-dose calcium
supplements are different: only take them if a doctor advises.
7
"A stone is something you swallowed." Stones grow inside the urinary tract from minerals already dissolved in urine.
19
"Only men get kidney stones." About 6 percent of US women get one too, and the gap has been narrowing.
113
"Every kidney stone needs an operation." Most stones, around 8 in 10, pass on their own.
9
"To avoid stones, avoid vegetables with oxalate." For most people a strict low-oxalate diet isn't the best approach; fruit and vegetables actually help prevent stones.
8
FAQ
What is the main cause of kidney stones?
Stones form when urine carries more stone-forming minerals, such as calcium, oxalate and phosphorus, than its water can keep dissolved. Not drinking enough liquid is one of the most common reasons: less water makes urine more concentrated, so minerals cluster into crystals.
What are kidney stones made of?
Most are calcium stones, and calcium oxalate stones are the most common kind. Other types are uric acid stones, struvite stones (which can form after a urinary tract infection) and rare cystine stones, which come from an inherited condition.
What foods cause kidney stones?
No single food causes a stone on its own. Diets high in salt (sodium) and animal protein raise the risk, and for people who have had calcium oxalate stones, very high-oxalate foods such as spinach, rhubarb, nuts and wheat bran may matter. Too much added sugar can also play a part.
How do you avoid getting a kidney stone?
Drink enough liquid, mainly water, so your urine stays pale yellow or almost clear; drink more in hot weather or when you sweat a lot. Eating less salt and getting normal amounts of calcium from food also help. People who have had a stone should ask a doctor about a plan for their stone type.
Why do men get kidney stones more than women?
In the US about 11 percent of men and 6 percent of women get a kidney stone at some point, and stones are most common in men in their 30s and 40s. The gap has been narrowing, because stones have become more common in women in recent decades.
Are kidney stones genetic?
They can run in families. A family history raises your risk, usually because many small gene differences combine with things like diet and how much you drink. A few rare conditions, such as cystinuria, are passed down directly.
What are the first warning signs of kidney stones?
Many small stones cause no symptoms. When a stone moves or blocks urine, it can cause sharp pain in the back, side, lower belly or groin, which may come in waves, plus blood in urine, nausea, or cloudy urine. Severe pain, fever or blood in urine means see a doctor right away.
Sources
- NIDDK (NIH), Definition & Facts for Kidney Stones
- NIDDK (NIH), Symptoms & Causes of Kidney Stones
- NIDDK (NIH), Eating, Diet, & Nutrition for Kidney Stones
- NIDDK (NIH), Treatment for Kidney Stones
- NIDDK (NIH), Your Kidneys & How They Work
- National Kidney Foundation, Kidney Stones
- National Kidney Foundation, How Do You Get Kidney Stones? Causes, Symptoms, and Prevention Tips
- National Kidney Foundation, Eat Smart to Prevent Kidney Stones
- Cleveland Clinic, Kidney Stones
- MedlinePlus Genetics (NIH), Kidney stones
- CDC, About Heat and Your Health
- OpenStax, Chemistry 2e, 11.3 Solubility
- Stamatelou K., Goldfarb D.S. (2023). Epidemiology of Kidney Stones. Healthcare 11(3):424
- NIDDK (NIH), The Urinary Tract & How It Works