Can Kidney Stones Cause Nitrites in Urine?
Finding nitrites in your urine often signals a bacterial infection — but what if you also have kidney stones? Can the two be connected?
The short answer is yes, indirectly. Kidney stones themselves do not produce nitrites, but they can create conditions that make bacterial growth — and therefore nitrite formation — more likely.
This article explains how kidney stones and nitrites in urine are related, what it means for your urinary health, and when to seek treatment.
What Are Nitrites in Urine?
Nitrites appear in urine when bacteria in the urinary tract convert nitrates (naturally present in urine) into nitrites. This process happens only with specific bacteria, such as Escherichia coli (E. coli), Klebsiella, and Proteus species — all common causes of urinary tract infections (UTIs).
A positive nitrite test on a urine dipstick usually indicates an active bacterial infection somewhere in the urinary system — from the bladder to the kidneys.
How Kidney Stones Contribute to Nitrites in Urine
Kidney stones themselves are hard mineral deposits that form when urine becomes too concentrated. While stones do not contain bacteria or produce nitrites, they can create an environment that promotes infection.
Here’s how:
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Urine Flow Obstruction:
Stones can partially block the flow of urine, allowing bacteria to accumulate and multiply. -
Injury to Urinary Tract Lining:
Stones can scratch or irritate the inner surfaces of the urinary tract, making it easier for bacteria to adhere and grow. -
Urine Stasis:
When urine doesn’t empty completely due to blockage, it provides a stagnant environment where bacteria thrive. -
Infection Stones (Struvite Stones):
Certain bacteria (Proteus, Klebsiella, Pseudomonas) can lead to the formation of struvite stones — also known as “infection stones.” These stones both result from and promote ongoing infection, often causing nitrites to appear in urine.
In short, kidney stones don’t make nitrites directly — but the infections they cause or worsen can.
Symptoms of Infection with Kidney Stones
If nitrites are found in your urine and you have kidney stones, you might experience:
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Pain in the lower back, flank, or abdomen.
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Fever or chills.
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Cloudy or foul-smelling urine.
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Burning or pain during urination.
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Nausea or vomiting.
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Blood in the urine (hematuria).
These symptoms may suggest a kidney infection (pyelonephritis), which can become serious if untreated.
Diagnosing Nitrites and Stones
Diagnosis involves checking for both infection and stone presence using:
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Urinalysis:
Detects nitrites, white blood cells (leukocytes), and bacteria in the urine. -
Urine Culture:
Identifies the bacteria type and determines the best antibiotic treatment. -
Imaging Tests:
Ultrasound, CT scan, or X-ray locates stones, measures their size, and shows if they’re blocking urine flow. -
Blood Tests:
Assess kidney function and detect infection markers.
Treatment Options
Treatment depends on whether infection or obstruction — or both — are present.
1. If Infection Is Present:
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Antibiotics are prescribed to eliminate bacteria.
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Fluids are encouraged to flush bacteria and reduce concentration.
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Severe infections may require intravenous (IV) antibiotics or hospitalization.
2. If Stones Are Present:
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Small stones may pass on their own with hydration and pain relief.
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Larger stones may need procedures such as:
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Extracorporeal shock wave lithotripsy (ESWL): Breaks stones into smaller pieces.
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Ureteroscopy: Removes stones through a small scope inserted into the urinary tract.
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Percutaneous nephrolithotomy: Surgical removal for large or complex stones.
If the infection is associated with struvite stones, both stone removal and antibiotic therapy are essential to prevent recurrence.
Why This Combination Can Be Dangerous
When infection and obstruction occur together, urine cannot drain properly, and bacteria multiply quickly. This can lead to:
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Kidney infection (pyelonephritis).
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Urosepsis (a life-threatening infection that spreads to the bloodstream).
If you have kidney stones and symptoms of infection — especially fever, chills, or back pain — seek emergency medical care immediately.
Preventing Nitrites in Urine with Kidney Stones
You can reduce your risk by:
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Drinking plenty of water to dilute urine and prevent stone formation.
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Treating UTIs promptly to avoid infection-related stones.
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Reducing salt and animal protein in your diet.
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Avoiding excessive supplements (such as calcium or vitamin D) unless prescribed.
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Urinating regularly and emptying your bladder completely.
For people with recurrent infections or stones, doctors may recommend periodic urine tests and imaging follow-ups.
When to See a Doctor
Contact your healthcare provider if you notice:
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Pain or burning when urinating.
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Cloudy or strong-smelling urine.
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Blood in urine.
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Fever, chills, or nausea.
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Sharp pain in the back or side.
Prompt treatment prevents complications and helps preserve kidney function.
The Bottom Line
Kidney stones themselves do not cause nitrites in urine, but they can trap bacteria and increase your risk of urinary infections. When bacteria multiply, they produce nitrites — a key sign of infection.
If nitrites are detected and stones are present, it’s important to treat both the infection and the obstruction to protect your kidneys and prevent recurrence.
Early diagnosis and proper medical care are the best ways to prevent serious complications.
Want to check your kidney health from home?
You can take an at-home kidney and urinary health test through Ribbon Checkup and get results in days.
Related Resources
Want to dive deeper into kidney health? Check out these helpful reads:
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The Complete Guide to At-Home Kidney Function Tests – Stay on top of kidney health with simple home testing.
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How Long Do Kidney Stones Last? Must Know – Get clarity on how long kidney stones typically last.
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What Can Mimic Kidney Stone Pain? – Learn about other conditions that cause similar pain.
References
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Khusid, J. A., & et al. (2021). Prevention and management of infectious complications of stone surgery. Frontiers in Surgery, 8, 718583. https://www.frontiersin.org/articles/10.3389/fsurg.2021.718583/full
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