Kidney stones and chronic kidney disease: what to know

A stone can obstruct urine flow from a kidney. If obstruction persists, pressure may build up and kidney function can be affected. Dehydration may make urine more concentrated and can increase the chance of stone formation. Chronic kidney disease means the kidneys have reduced filtering ability over time; the amount of fluid you should drink and the medicines you can use may therefore differ from general advice.

Kidney stones may cause severe flank pain, blood in the urine, nausea or painful urination. Chronic kidney disease can exist without obvious symptoms, although fatigue or excessive thirst may occur. These symptoms are not specific, so testing is needed rather than guessing the cause.

Arrange a clinical review if you have known chronic kidney disease and possible stone symptoms, especially if pain is persistent or you are passing less urine. A clinician may check urine, blood kidney-function markers and imaging for obstruction. Do not start leftover pain medicines or herbal remedies without checking that they are suitable for your kidney function.

Follow your existing kidney-care plan, keep any prescribed blood-pressure or diabetes treatment consistent, and ask how much fluid is appropriate for you. If a stone is passed, keep it only if your clinician recommends analysis; its composition can guide prevention.

Seek urgent medical care for fever or chills with flank pain, vomiting that prevents fluids, new confusion, faintness, severe worsening pain, or difficulty passing urine. A blocked urinary system with infection can become serious quickly. People with chronic kidney disease should use a lower threshold for prompt review because reduced kidney reserve can make illness harder to tolerate.

Ask whether your symptoms could reflect obstruction, infection or another cause; which pain relief is safe with your kidney function; whether imaging is needed; what fluid plan fits your condition; and how to reduce the chance of future stones.