16378 Uric Acid Stones

Overview

Uric acid stones are a type of kidney stone. They form when the urine becomes too acidic and uric acid crystals clump together. These stones can cause pain, usually in the back or side, and can affect how well the kidneys work.

Kidney stones affect about 1 in 10 people at some point in their lives. Uric acid stones are one of the most common types, especially in adults.

Uric acid stones are more common in men, people over 40, and those with conditions like gout, diabetes, or metabolic syndrome. They can also run in families.

Symptoms

Common symptoms

• Sharp, severe pain in the back, side, or lower abdomen (sometimes called renal colic)
• Pain that comes in waves and moves as the stone shifts
• Pain during urination
• Blood in the urine (pink, red, or brown)
• Frequent urge to urinate
• Nausea or vomiting

Symptoms in children

• Children may complain of stomach pain rather than back pain
• Unexplained fever
• Blood in the urine
• Bedwetting in a child who was previously dry at night

Symptoms in older adults

• Older adults may have fewer typical symptoms and more confusion or a general feeling of being unwell
• Pain may be less intense or felt as a dull ache
• Changes in urination, such as urgency or frequency
• Signs of a urinary tract infection, like fever or chills

Causes

Main causes

• Urine that is too acidic — uric acid dissolves best in urine with a balanced pH
• Not drinking enough water, which makes urine concentrated
• Eating a diet very high in 'purines' — substances found in red meat, organ meats, and certain seafood
• Certain medical conditions, such as gout or metabolic syndrome
• Some medicines (for example, certain diuretics or aspirin) can raise uric acid levels — always ask your doctor about your medicines

Risk factors

• Being male
• Obesity or overweight
• Diabetes or insulin resistance
• Chronic diarrhea or conditions that cause fluid loss
• A family history of kidney stones
• A diet high in animal protein and low in fruits and vegetables

When to see a doctor

See a doctor urgently if:

• If you have sudden severe pain in your back or side
• If you see blood in your urine
• If you have fever or chills with your symptoms
• If you cannot urinate

Book a routine appointment if:

• If you have mild pain that keeps coming back
• If you have previously had kidney stones and want to prevent more
• If you have changes in your urine color or flow

Diagnosis

Your doctor will ask about your symptoms, examine you, and order tests to look for kidney stones and check for uric acid crystals in your urine.

Tests that may be done

• Urine test: detects crystals, blood, or signs of infection
• Blood test: checks kidney function, uric acid level, and other minerals
• Imaging scans (like a CT scan or ultrasound) to see where the stone is and how big it is
• Stone analysis: if you pass a stone, it can be sent to a lab to find out what it is made of

What to expect at your appointment

You may be asked to drink plenty of water and collect your urine over 24 hours. In the emergency department, you may be given pain relief and fluids through a drip. Later, results will help your doctor decide whether you can pass the stone naturally or need further treatment.

Treatment

Treatment depends on the size and location of the stone, the severity of your symptoms, and whether the stone is blocking urine flow. The goal is to relieve pain, help the stone pass, and prevent new stones from forming.

Self-care at home

• Drink at least 2 to 3 litres of water a day (unless your doctor tells you otherwise) to produce plenty of clear urine
• Take over-the-counter pain relief as recommended by your pharmacist or doctor (never exceed the label dose)
• Use a hot bath or heating pad on your side for comfort
• Move around gently — changing positions may help the stone pass
• Strain your urine through a fine sieve to catch the stone for testing

Medical treatments

Your doctor may prescribe medicines to help relax the urinary tract so stones pass more easily. For uric acid stones, they may also prescribe a medicine to make your urine less acidic. This helps existing stones dissolve and prevents new ones. Always take any medicine exactly as prescribed, and discuss concerns with your doctor.

When is surgery considered?

If the stone is too large to pass, is causing severe blockage, or threatens kidney function, a specialist may recommend a procedure to remove it. Common approaches include sound waves to break up the stone (extracorporeal shock wave lithotripsy), a thin tube passed through the urinary tract (ureteroscopy), or rarely, surgery through a small cut in the back.

Living with this condition

After a uric acid stone, your main job is to keep urine diluted and less acidic. Drink water throughout the day, not just when you feel thirsty. Keep a water bottle handy. Your doctor may give you a diet sheet or refer you to a dietitian.

Lifestyle tips

• Aim for 6 to 8 glasses of water a day, and more if it is hot or you exercise
• Limit alcohol, especially beer, which can raise uric acid levels
• Cut back on sugary drinks and foods with high-fructose corn syrup
• Maintain a healthy weight gradually — avoid crash diets
• If you have gout or diabetes, keep those conditions well controlled

Diet and exercise

Eat a balanced diet with plenty of vegetables, fruits, and whole grains. You do not need to cut out meat completely, but eat smaller portions of red meat, organ meats, and shellfish. Regular physical activity helps with weight control and overall health — just stay well hydrated before, during, and after exercise.

Mental health and emotional wellbeing

Living with kidney stones can be stressful, especially if the pain is severe or stones keep coming back. It is normal to feel anxious or frustrated. If you feel overwhelmed, talk to your doctor or a counsellor. In a crisis, contact your local emergency or mental health helpline.

Prevention

Yes, in many cases. Drinking enough water and keeping your urine less acidic are the two most effective steps. For people who keep making uric acid stones, a doctor may suggest long-term medication to lower uric acid levels or change urine pH.

Vaccines

Not applicable.

Screening programmes

There is no routine screening for uric acid stones in the general population. If you have a history of stones, your doctor may recommend periodic urine and blood checks.

Complications

If left untreated

• Complete blockage of urine flow, which can damage the kidney over time
• Kidney infection (pyelonephritis), which can spread into the bloodstream
• Chronic kidney disease, especially with recurrent large stones
• Severe pain and frequent emergency visits

Long-term outlook

With the right treatment and prevention steps, most people recover fully and can avoid future stones. Even if you have had stones before, following a kidney-friendly diet and staying well hydrated can make a big difference. Your medical team will guide you at every step.

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