kidney stone in older adults

Overview

A kidney stone is a hard, pebble-like piece of material that can form in one or both kidneys. It happens when urine becomes too concentrated and minerals and salts stick together. In older adults, kidney stones may be more likely due to dehydration, long-term health conditions, or certain medicines.

Yes. About 1 in 10 people will have a kidney stone at some point in their life, and rates in older adults have been increasing over recent years.

Anyone can get a kidney stone, but they are more common in men and in people over 50. People with diabetes, high blood pressure, or a history of dehydration are also at higher risk.

Symptoms

Common symptoms

• Severe pain in the lower back, side, or belly that comes in waves
• Pain that spreads down to the groin or inner thigh
• Pink, red, or cloudy urine
• Needing to urinate more often or feeling burning when urinating
• Nausea or vomiting

Symptoms in children

• Stomach pain that seems severe for no clear reason
• Blood in the urine
• A urinary tract infection that keeps coming back

Symptoms in older adults

• A dull or vague ache in the back or belly instead of sharp pain
• Sudden confusion, drowsiness, or unsteadiness
• Feeling generally unwell, tired, or weak
• Fever with chills, which may mean an infection is present
• Urinary symptoms like urgency or frequent urination

Causes

Main causes

• Not drinking enough fluids, leading to concentrated urine
• A diet high in salt or certain proteins
• Long-term urinary tract infections
• Certain medicines used for other health conditions, such as some treatments for high blood pressure, calcium supplements, or diuretics
• A family history of kidney stones

Risk factors

• Being over the age of 60
• Having had a kidney stone before
• Reduced thirst or limited mobility, which can lead to dehydration
• Health conditions like diabetes, gout, or inflammatory bowel disease
• Enlarged prostate in men or an overactive bladder
• Long periods of bed rest or being immobile

When to see a doctor

See a doctor urgently if:

• If you have a fever, vomiting, confusion, or cannot pass urine, seek medical care the same day.
• If you have severe pain that is not helped by over-the-counter pain relief, call your doctor or go to urgent care.
• If you see blood in your urine, especially with pain or fever, get it checked promptly.

Book a routine appointment if:

• If you have dull back pain or belly discomfort that lasts more than a day or two.
• If you notice changes in urination, such as urgency, frequency, or unusual colour.
• If you have had a kidney stone before and want advice on lowering your risk of another one.

Diagnosis

Your doctor will ask about your symptoms, examine your back and abdomen, and check your temperature and blood pressure. They will usually ask for a urine sample and a blood test to check how your kidneys are working.

Tests that may be done

• Urine test to look for blood, infection, or tiny crystals
• Blood tests to check kidney function and look for signs of infection
• Imaging scans, such as a CT scan or an ultrasound, to find the exact location and size of the stone

What to expect at your appointment

Results may take a few days. If the stone is small, the doctor may suggest drinking extra fluids and collecting your urine through a strainer to catch the stone. If the stone is large or blocking the flow of urine, you may be referred to a specialist called a urologist.

Treatment

Treatment depends on the size, location, and symptoms of the stone. Most kidney stones in older adults can be managed safely without surgery. Your doctor will help you decide the best course based on your overall health.

Self-care at home

• Drink plenty of water or other clear fluids to help move the stone along.
• Use a heating pad on your back or side to help with pain and muscle tension.
• Rest when you feel tired, but try to take short walks to encourage the stone to move.
• Follow the dosage instructions on any over-the-counter pain relief you choose, and ask your pharmacist if it is safe for you.

Medical treatments

Doctors may prescribe medicines to help relax the tube between the kidney and bladder, making it easier for the stone to pass. If you have a urinary infection, antibiotics will be given. For larger stones, treatments like shock wave lithotripsy, ureteroscopy, or keyhole surgery are common. Your urologist will explain the options and what to expect.

When is surgery considered?

Surgery is usually needed if the stone is too large to pass on its own, if it is completely blocking the flow of urine, if it causes severe pain that cannot be controlled, or if there is a serious infection.

Living with this condition

While you are recovering from a kidney stone, drink enough fluids to keep your urine pale yellow. You may need to take pain relief for a few days. Keep your doctor updated if your symptoms change or do not improve.

Lifestyle tips

• Drink 6 to 8 glasses of fluid a day unless your doctor tells you otherwise.
• Eat less salt and avoid processed foods high in sodium.
• Limit sugary fizzy drinks and sweetened juices.
• Stay as active as you safely can — walking is a good option.

Diet and exercise

A balanced diet with normal amounts of calcium from food is usually recommended. You do not need to stop eating milk, yoghurt, or leafy greens. Gentle exercise like walking or stretching is helpful, but avoid heavy lifting or intense activity during an acute stone episode.

Mental health and emotional wellbeing

Living with repeated kidney stones can be worrying and stressful. It is completely normal to feel anxious, especially if you are older and managing other health problems. Talk to your doctor if you feel low — they can point you to counselling or support services.

Prevention

For many people, yes. Staying well hydrated, reducing salt in your diet, and maintaining a healthy weight can significantly lower your risk. If you have had a stone, your doctor may test your urine and blood to identify why stones form and give you personalised advice.

Complications

If left untreated

• A stone blocking the flow of urine can cause the kidney to swell (hydronephrosis), which is painful and can damage the kidney.
• Infection can spread from the kidney into the blood, leading to a life-threatening condition called sepsis.
• Scarring inside the urinary tract may develop over time and reduce how well the kidneys work.

Long-term outlook

The outlook for kidney stones in older adults is very good, especially with prompt care. Most stones pass without any lasting damage, and even larger stones can be treated effectively with modern procedures. With the right support and prevention steps, you can keep your kidneys healthy and reduce the chance of stones returning.

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