Nephrolithiasis (Kidney Stones) Quiz
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Low back pain
I have back pain
Localized abdominal pain
Stomachache
Have periodic abdominal pain
Have nausea
Pain on one side started first
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What is Nephrolithiasis (Kidney Stones)?
A condition in which stones form in the kidney and may eventually pass through the ureter (tube connecting the kidney and bladder) to the bladder before exiting the urethra. Small stones may pass on their own, but larger stones may need to be removed by procedures or surgery.
Typical Symptoms of Nephrolithiasis (Kidney Stones)
- Symptoms started with lower back pain on one side only
- Noticed a small stone come out when passing urine
- Stomach or abdominal pain in a specific area
- Pain when tapping lower back
- Back pain or discomfort
- Lower back pain
- History of urinary stones
- Blood in urine
Diagnostic Questions for Nephrolithiasis (Kidney Stones)
Your doctor may ask these questions to check for this disease:
- Did you have lower back pain on one side only when your symptoms started?
- Did you pass any urinary stones while urinating?
- Do you have stomach or abdominal pain in a specific area?
- Does it hurt when you tap your lower back?
- Are you experiencing any back pain or discomfort?
Treatment of Nephrolithiasis (Kidney Stones)
Treatment depends on the size of the stone. A small stone may pass on its own - patients are asked to drink more water and take painkillers in the meantime. They may also be asked to take a medication to relax the ureters to allow passage of the stone. Larger stones may need procedures like shockwave therapy, which uses sound waves to break up a large stone into smaller pieces that are easily passed. Finally, if the stone is too large surgery may be needed to remove the stone.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Nao Saito, MD (Urology)
After graduating from Tokyo Women's Medical University School of Medicine, Dr. Saito worked at Tokyo Women's Medical University Hospital, Toda Chuo General Hospital, Tokyo Women's Medical University Yachiyo Medical Center, and Ako Chuo Hospital before becoming Deputy Director (current position) at Takasaki Tower Clinic Department of Ophthalmology and Urology in April 2020.
Content updated on Dec 5, 2025
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Stone passing through urethra
- Passing small stones in urine
- Passed a stone in urine
- Painful urination
- Lower part of the back has pain
- Pain in the upper back
- Pain in the spine
- Lumbar spine pain
- Shoulder blade hurts
- Pain in the left shoulder blade
- Back pain triggered by movement
- Back pain worsens with alcohol intake
- Pain when pressed on the back
- Ache in the upper back
- Back pain
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User Testimonials for Nephrolithiasis (Kidney Stones)
Female, Teens
Ubie outlined several possibilities of what I was going through, including a urinary tract infection (UTI) and kidney stones. This information helped me realize I needed immediate medical attention, and I went to see an Emergency Medicine Physician.
(Jan 31, 2025)
Symptoms Related to Nephrolithiasis (Kidney Stones)
Diseases Related to Nephrolithiasis (Kidney Stones)
FAQs
Q.
Sudden Pain? What Causes Kidney Stones & Medical Next Steps
A.
Kidney stones most often result from dehydration, diet, genetics, or conditions like gout or diabetes; hallmark symptoms include sudden sharp side or back pain, blood in the urine, and nausea, and you should seek urgent care for fever, severe pain, vomiting, trouble urinating, or a single kidney. Small stones may pass with fluids, pain relief, and medications to relax the ureter, while larger or complicated stones may require shock wave lithotripsy, ureteroscopy, or minimally invasive surgery. There are several factors that can change your next steps and prevention plan, including stone type and underlying conditions; see the complete details below.
References:
* Mousa O, et al. Update on the Pathophysiology and Treatment of Kidney Stones. J Clin Med. 2023 Feb 1;12(3):1140. doi: 10.3390/jcm12031140. PMID: 36769649; PMCID: PMC9917390.
* Asch M, et al. Diagnosis and Medical Management of Kidney Stones: A Narrative Review. Am J Med. 2022 Dec;135(12):1414-1420. doi: 10.1016/j.amjmed.2022.06.009. Epub 2022 Jun 21. PMID: 35749774.
* Alsaikhan B, et al. Epidemiology and Risk Factors of Nephrolithiasis: A Narrative Review. Medicina (Kaunas). 2023 May 31;59(6):1063. doi: 10.3390/medicina59061063. PMID: 37374465; PMCID: PMC10300959.
* Müller F, et al. Guidelines for the medical management of kidney stones. Transl Androl Urol. 2022 Aug;11(8):1052-1065. doi: 10.21037/tau-22-383. Epub 2022 Aug 30. PMID: 36118037; PMCID: PMC9472391.
* Chee V, et al. Medical prevention of kidney stones in adults: An updated narrative review. World J Urol. 2022 Aug;40(8):1891-1897. doi: 10.1007/s00345-022-05004-w. Epub 2022 Jun 13. PMID: 35697672; PMCID: PMC9339387.
Q.
Is it Kidney Stone Symptoms? Why Your Body is Hurting & Medically-Approved Next Steps
A.
Sudden, severe pain in your side or lower back that can radiate to the groin, plus painful or frequent urination and blood in the urine, often points to kidney stones; nausea or vomiting may occur, and fever or chills with these symptoms signals an emergency. Next steps include urgent care if you have fever, uncontrollable pain, persistent vomiting, or trouble urinating; otherwise increase fluids if you can keep them down, use appropriate pain relief, and see a clinician for tests and imaging to confirm and guide treatment. There are several factors to consider for your specific case; see below for complete details that could change which next steps are safest.
References:
* Russo, M., Cindolo, L., Cestari, A., & Cindolo, L. (2022). Clinical presentation of acute flank pain: a narrative review. *Minerva Urology and Nephrology*, *74*(5), 551-561.
* Kamal, N. (2022). Renal Colic: Pathophysiology, Diagnosis, and Treatment. *The Journal of Emergency Medicine*, *62*(3), e275-e283.
* Clements, T., & Saarela, K. (2022). Acute Renal Colic: An Emergency Department Perspective. *Emergency Medicine Clinics of North America*, *40*(3), 517-531.
* Khan, S. R., Canales, B. K., & Daudon, M. (2021). Urolithiasis: a comprehensive review. *Nature Reviews Disease Primers*, *7*(1), 1-22.
* Zhu, M. C., & Zhang, Y. T. (2020). Current Concepts in the Diagnosis and Management of Urolithiasis. *Frontiers in Surgery*, *7*, 607412.
Q.
Hydronephrosis? Why Your Kidney Is Swelling & Medically Approved Next Steps
A.
Hydronephrosis is kidney swelling caused by blocked urine flow; common triggers include kidney stones, an enlarged prostate, infections, pregnancy, tumors, or scarring, and symptoms range from flank or back pain and urinary changes to fever, with infected obstruction or inability to urinate needing urgent care. Medically approved next steps include prompt evaluation with ultrasound or CT plus urine and blood tests, then targeted treatment such as pain control, fluids when appropriate, antibiotics for infection, stone removal, or temporary drainage with a stent or nephrostomy to protect kidney function; there are several factors to consider, so see the complete guidance below for details that can change your next steps.
References:
* Ramakrishnan K, Nanjappa M. Hydronephrosis in Adults: Etiology, Diagnosis, and Treatment. Cureus. 2023 Dec 19;15(12):e50849. doi: 10.7759/cureus.50849. PMID: 38240259; PMCID: PMC10795449.
* Nardi G, Tappero S, Marra T. Hydronephrosis. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: PMID: 32809627.
* Saliou AA, Ndiaye M, Diop S, Diao B, Diallo MB, Jalloh M, Gueye SM. Acute ureteral obstruction: epidemiology, diagnosis, and management. Clin Kidney J. 2020 Oct 30;13(5):770-779. doi: 10.1093/ckj/sfaa144. PMID: 33178491; PMCID: PMC7644910.
* Rais-Bahrami S, Masson P, Friedlander JI. Management of Ureteropelvic Junction Obstruction in Adults: Evidence-Based Approach. Urol Clin. 2021 Feb;48(1):61-70. doi: 10.1016/j.ucl.2020.08.006. PMID: 33162121.
* O'Connor KR, Sayegh JS. Urinary Tract Obstruction in Adults: Diagnosis and Treatment. Mayo Clin Proc. 2020 Nov;95(11):2465-2475. doi: 10.1016/j.mayocp.2020.04.041. PMID: 33153670.
Q.
Is it Kidney Pain? Why Your Flank Hurts & Medically Approved Next Steps
A.
Kidney-related flank pain is usually a deep ache or severe cramping just below the ribs that does not change with movement and may come with urinary symptoms, fever, nausea, or pain radiating to the groin. There are several factors to consider; see below for key differences from muscle pain, common causes like stones or infection, and when it is urgent. For mild, short-lived pain, rest, hydration, and monitoring can be reasonable, but seek prompt care for severe or persistent pain, fever, vomiting, blood in urine, decreased urination, or if you have kidney disease or are pregnant. Important details on diagnosis, risk factors, prevention, and medically approved next steps are outlined below.
References:
* Drago S, Di Paolo S, Campioni P, Messina S, Stagni S. Acute Flank Pain: A Systematic Approach to Diagnosis and Management. Mayo Clin Proc. 2018 Jun;93(6):790-802. doi: 10.1016/j.mayocp.2018.02.019. PMID: 29887710.
* Portis AJ, Abdi H, D'Avanzo E, Mufarrij P. Renal Colic: Evaluation and Management. Med Clin North Am. 2020 Jul;104(4):759-773. doi: 10.1016/j.mcna.2020.04.004. Epub 2020 May 9. PMID: 32675549.
* Ramakrishnan K, Lahr BD, Steckelberg JM, Wilson WR, Sampathkumar P. Acute pyelonephritis: diagnosis and management. Curr Opin Infect Dis. 2019 Jun;32(3):284-290. doi: 10.1097/QCO.0000000000000547. PMID: 31088647.
* Cohan RH, Ellis JH. Imaging of Acute Flank Pain: A Review. Radiol Clin North Am. 2020 Jan;58(1):15-28. doi: 10.1016/j.rcl.2019.09.002. Epub 2019 Oct 29. PMID: 32064136.
* Zeltser R, Flaster P. Approach to the Patient With Flank Pain. Emerg Med Clin North Am. 2014 May;32(2):459-73. doi: 10.1016/j.emc.2014.01.008. Epub 2014 Feb 27. PMID: 24707297.
Q.
Kidney Stone Symptoms? Why Your Side Is Aching & Medically Approved Next Steps
A.
Kidney stone symptoms often include sudden, severe side or back pain that comes in waves and can radiate to the groin, along with blood in the urine, burning when urinating, frequent urges, and nausea or vomiting; fever or chills are red flags for an infected blockage and need urgent care. Doctors confirm with urine and blood tests plus imaging, then treat with pain control, fluids, and medications to help small stones pass or with procedures if needed; there are several factors that can change your next steps and timing, so see the complete guidance below for when to seek immediate care, how treatment is chosen, and prevention tips.
References:
* Khan SR, Pearle MS, Preminger GM, Nakada SY. Kidney Stones: Epidemiology, Pathophysiology, Diagnosis, and Management. J Clin Med. 2022 Feb 21;11(4):1127. doi: 10.3390/jcm11041127. PMID: 35268487; PMCID: PMC8873041.
* Al-Ansari A, Al-Marri A. Acute Renal Colic: An Evidence-Based Approach to Diagnosis and Management. Intern Med J. 2020 Jul;50(7):793-802. doi: 10.1111/imj.14872. Epub 2020 Jun 21. PMID: 32415951.
* Goldflam K, Saavedra M, Matasar M. Evaluation and Management of Patients with Renal Colic. Emerg Med Clin North Am. 2022 May;40(2):295-309. doi: 10.1016/j.emc.2022.01.006. Epub 2022 Mar 22. PMID: 35461622.
* Da Costa M, Singh M, Leslie SW. Urolithiasis: An Update on Medical Management and Prevention. Rev Urol. 2023;25(1):1-14. PMID: 37376784; PMCID: PMC10292728.
* Türk C, Petritsch B, Lantschner L, Remzi M, Uribarri C, Tailly T, Skolarikos A, Sarica K, Gravas S, Omar MI, Neisius A, Traxer O, de la Rosette J, Osther PJS. EAU Guidelines on Urolithiasis. Eur Urol. 2024 Mar 4:S0302-2838(24)00155-2. doi: 10.1016/j.eururo.2024.02.013. Epub ahead of print. PMID: 38453676.
Q.
Is It Just Back Pain? Why Your Kidney Is Aching & Medical Next Steps
A.
Kidney pain typically feels like a deep, one-sided ache in the upper back or flank that does not improve with position changes and is often paired with urinary symptoms or fever, pointing to causes like a kidney infection or kidney stones rather than simple muscle strain. Seek urgent care for fever with flank pain, severe or worsening pain, vomiting, blood in urine, confusion, or signs of dehydration; clinicians confirm the cause with urine, blood, and imaging tests and treat infections promptly with antibiotics. There are several factors to consider, so see the complete next steps and important details below.
References:
* pubmed.ncbi.nlm.nih.gov/32098270/
* pubmed.ncbi.nlm.nih.gov/29549303/
* pubmed.ncbi.nlm.nih.gov/35008453/
* pubmed.ncbi.nlm.nih.gov/35848520/
* pubmed.ncbi.nlm.nih.gov/34185123/
Q.
Kidney Stone? Why Your Side Hurts & Medically Approved Next Steps
A.
Sudden, severe side or back pain that comes in waves and may radiate to the groin, often with blood in the urine or nausea, is typical of a kidney stone; medically approved next steps range from fluids, pain control, and sometimes tamsulosin for small stones to procedures for larger or complicated stones. Seek immediate care for fever, uncontrollable pain, persistent vomiting, trouble urinating, pregnancy, or a single kidney. There are several factors to consider that could change your next steps; see below for complete guidance on diagnosis, timing, treatment choices, and prevention.
References:
* Bhattarai H, Sharma BK, Kharel S, Karki A. Update on the Pathophysiology, Diagnosis, and Treatment of Renal Colic. World J Nephrol. 2022 May 25;11(3):36-54. doi: 10.5527/wjn.v11.i3.36. PMID: 35500508; PMCID: PMC9133868.
* Khan SR, Pearle MS, Khan A, Adams-Huet B, Preminger GM. Urolithiasis: a comprehensive review of diagnosis, management, and prevention. Nat Rev Nephrol. 2023 Jun 2. doi: 10.1038/s41581-023-00720-x. Epub ahead of print. PMID: 37267104.
* Chouhan J, Sharma A, Pandey U, Singh D, Kadian M, Kumar S. Management of acute renal colic due to ureteral stones in the emergency department. J Postgrad Med. 2022 Jul-Sep;68(3):149-156. doi: 10.4103/jpgm.jpgm_144_22. Epub 2022 Aug 1. PMID: 35919420.
* Monga M, Antonelli JA. The Medical Evaluation and Management of Kidney Stones. Med Clin North Am. 2022 Apr;106(2):339-354. doi: 10.1016/j.mcna.2021.11.002. Epub 2021 Dec 2. PMID: 34882585.
* Lau B, Lipkin ME. Minimally Invasive Treatments for Urolithiasis: A Review. Urol Clin North Am. 2023 Aug;50(3):361-372. doi: 10.1016/j.ucl.2023.04.008. Epub 2023 Jun 2. PMID: 37266627.
Q.
Sharp Side Pain? Why Your Kidneys are Forming Stones & Medical Next Steps
A.
There are several factors to consider: sharp, wave-like side or back pain that radiates to the groin often signals kidney stones, which form when concentrated urine lets minerals crystallize due to dehydration, diet, genetics, medical conditions, or certain medicines. Seek urgent care for fever, vomiting, inability to urinate, or uncontrolled pain. Otherwise, imaging and urine tests guide treatment from fluids and pain control to lithotripsy or surgery, and prevention centers on more fluids, less sodium, moderate protein, normal calcium intake, weight management, and 24-hour urine guided therapy; see the complete next steps and key details below.
References:
* Khan SR, Pearle MS, Robertson WG, Gambaro G, Canales BK, Doizi S, et al. Kidney stone formation: causes, mechanisms, and therapeutic approaches. *Nat Rev Nephrol*. 2016 Nov;12(11):693-702. doi: 10.1038/nrneph.2016.121. Epub 2016 Aug 30. PMID: 27573037.
* Ramello A, Stasi A, Marra F, Castellano G, Divella C. Pathophysiology, clinical presentation and diagnosis of kidney stones: a review. *Clin Chim Acta*. 2024 Mar 22;555:117822. doi: 10.1016/j.cca.2024.117822. Epub ahead of print. PMID: 38514214.
* Daudon M, Frochot V, Bazin D. Nephrolithiasis: Pathogenesis, Diagnosis, and Management. *Clin Chim Acta*. 2020 Jan;500:231-242. doi: 10.1016/j.cca.2019.10.038. Epub 2019 Oct 29. PMID: 31693892.
* Chew BH, Pasternak S, MacNeily AE. Medical Management of Kidney Stones: A 2023 Update. *J Urol*. 2023 Sep;210(3):418-428. doi: 10.1097/JU.0000000000003509. Epub 2023 Jun 20. PMID: 37340801.
* Sarica K, Tan A, Akdemir Y. Metabolic Evaluation and Medical Prevention of Stone Recurrence. *J Endourol*. 2017 Mar;31(S1):S10-S14. doi: 10.1089/end.2016.0381. Epub 2017 Jan 16. PMID: 28095642.
Q.
Passing Razor Blades? Why Your Kidneys Form Stones & Medically-Approved Next Steps
A.
Kidney stones form when minerals in concentrated urine crystallize, causing severe back or side pain that can radiate to the groin; small stones may pass with hydration, pain control, and sometimes alpha blockers, while larger or complicated stones are treated with shock wave lithotripsy, ureteroscopy, or percutaneous removal. There are several factors to consider, including dehydration, high salt and animal protein intake, certain conditions and medicines, and stone type, plus prevention steps like more fluids, sodium reduction, and tailored advice after testing; seek urgent care for fever, persistent vomiting, or inability to urinate. See the complete next steps, red flags, and prevention details below.
References:
* Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Taddeo D, Tzortzis V, Skolarikos A. Kidney Stone Formation: An Update on Molecular Mechanisms and Therapeutic Targets. World J Urol. 2021 Nov;39(11):3935-3944. PMID: 34524855.
* Asplin JR. Medical Management of Kidney Stones: A Review. JAMA. 2023 Sep 19;330(11):1075-1081. PMID: 37733475.
* López M, Hoppe B. Nephrolithiasis: Pathophysiology, Diagnosis, and Management. Pediatr Clin North Am. 2020 Apr;67(2):215-231. PMID: 32187641.
* Coe FL, Worcester EM, Evan AP. Medical Prevention of Recurrent Nephrolithiasis. Clin Rev Bone Miner Metab. 2020 Dec;18(4):307-319. PMID: 33054199.
* Crivelli JJ, De Los Reyes D, Patel N, Asplin JR, Shiao W, Lundy SD. Dietary and Lifestyle Changes for the Prevention of Kidney Stones: A Narrative Review. Curr Urol Rep. 2024 Feb;25(2):147-156. PMID: 38303036.
Q.
Kidney Stones in Women: Signs, Prevention & Your Action Plan
A.
Kidney stones in women often present with sudden sharp back or side pain that can move to the lower abdomen or groin, along with burning or frequent urination and blood in the urine; fever, chills, severe unrelenting pain, trouble passing urine, or vomiting that prevents fluids are warning signs that need urgent care, and doctors diagnose with urine and blood tests plus imaging. Prevention centers on drinking 2 to 3 liters of fluids daily, lowering sodium, keeping normal dietary calcium, moderating animal protein, managing weight, and promptly treating UTIs, with small stones often passing at home and larger ones requiring procedures. There are several factors to consider, including pregnancy and when to call a doctor; see complete details below to guide your next steps.
References:
* Penniston KL, Averch TD, Nakada SY, Antonelli JA, Best SL, Preminger GM, Scales CD Jr. Kidney stone disease in women: an expanding problem. Rev Urol. 2018;20(1):15-22. PMID: 29705910.
* Saripalli S, Zuniga P, Ferraro PM, Penniston KL. Medical prevention of nephrolithiasis in women: an update. Urolithiasis. 2022 Feb;50(1):13-26. PMID: 35000787.
* Ferraro PM, Saripalli S, Penniston KL. Management of Urolithiasis in Women. Curr Urol Rep. 2021 Jul 2;22(8):47. PMID: 34160456.
* Sorokin I, Mamoulakis C, Miyazawa K, Rodgers A, Seitz C, Somani B, D'Addessi A, De Sio M, Bader MJ, Preminger GM, Penniston KL. Sex Differences in Kidney Stone Disease. World J Urol. 2020 Nov;38(11):2725-2734. PMID: 32675685.
* Ferraro PM, Penniston KL, Tan K, Raggi P, Gambaro G, Vezzoli G, Abate N, Goldfarb DS. Sex-Specific Risk Factors for Incident Kidney Stones. J Am Soc Nephrol. 2021 May;32(5):1227-1236. PMID: 33737077.
Q.
What are the recommended diet for kidney stones ? Are there things to avoid?
A.
General diet recommendations for kidney stones include drinking plenty of water, eating foods with enough calcium and avoiding certain foods.
References:
Zayed S, Goldfarb DS, Joshi S. Popular Diets and Kidney Stones. Adv Kidney Dis Health. 2023 Nov;30(6):529-536. doi: 10.1053/j.akdh.2023.10.002. PMID: 38453270.
Siener R. Nutrition and Kidney Stone Disease. Nutrients. 2021 Jun 3;13(6):1917. doi: 10.3390/nu13061917. PMID: 34204863; PMCID: PMC8229448.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Bultitude M. Urolithiasis around the world. BJU Int. 2017 Nov;120(5):601. doi: 10.1111/bju.14033. PMID: 29035016.
https://onlinelibrary.wiley.com/doi/10.1111/bju.14033Quhal F, Seitz C. Guideline of the guidelines: urolithiasis. Curr Opin Urol. 2021 Mar 1;31(2):125-129. doi: 10.1097/MOU.0000000000000855. PMID: 33399368.
https://journals.lww.com/co-urology/Abstract/2021/03000/Guideline_of_the_guidelines__urolithiasis.11.aspxTürk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol. 2016 Mar;69(3):468-74. doi: 10.1016/j.eururo.2015.07.040. Epub 2015 Aug 28. PMID: 26318710.
https://www.sciencedirect.com/science/article/abs/pii/S0302283815006995?via%3Dihub