The Link Between Kidney Stones and Diabetes

Living with diabetes means paying attention to many aspects of your health. While you're likely familiar with monitoring your blood sugar and watching for signs of neuropathy, you might not realize that diabetes significantly increases your risk of developing kidney stones.

Research shows that having type 2 diabetes more than doubles your chances of developing kidney stones. And if you use insulin to manage your condition, your risk may be even higher. But why does this happen, and what can you do about it?

What happens to your kidneys when you have diabetes?

When you have diabetes, consistently high blood sugar levels can damage the tiny blood vessels in your kidneys over time. 

Your kidneys work as your body's filtering system, removing waste while balancing important minerals and fluids.  This damage affects how your kidneys function, including how they filter minerals like calcium and substances like uric acid. These changes create the perfect environment for kidney stones to form.

Research indicates a significant association between diabetes and an increased risk of kidney stones. A study published in the Journal of Clinical Endocrinology & Metabolism found that individuals with type 2 diabetes had a 2.44 times higher likelihood of developing kidney stones compared to those without diabetes. 

High blood sugar also makes your urine more acidic, which further increases your risk of developing certain types of kidney stones.

Why diabetes and kidney stones often occur together

The connection between these two conditions isn't just a coincidence. Several factors link diabetes and kidney stones, like insulin resistance affecting mineral balance, urine acidity due to diabetes, increased dehydration risk, and metabolic syndrome. 

Insulin resistance affects mineral balance. When your body doesn't respond properly to insulin, it changes how your kidneys handle calcium. More calcium ends up in your urine, creating ideal conditions for calcium stones to form.

Acidic urine creates problems. People with diabetes often have more acidic urine due to the way their bodies process certain substances. This acidity makes it easier for uric acid stones to develop. Learn more about urine pH levels.

Dehydration risk increases. Uncontrolled diabetes causes frequent urination, which can lead to dehydration if you don't drink enough fluids. When you're dehydrated, your urine becomes more concentrated, making stone formation more likely.

Metabolic syndrome compounds the issue. This cluster of conditions often accompanies type 2 diabetes and independently raises kidney stone risk through multiple pathways.

Types of kidney stones you might develop

Calcium stones are the most common type for everyone, including people with diabetes. They form when calcium binds with other substances in your urine, particularly oxalate. Research shows that insulin resistance can increase the amount of calcium in your urine by up to 30%.

Uric acid stones occur much more frequently in people with diabetes. A study in the Clinical Journal of the American Society of Nephrology found that about 40% of kidney stones in people with diabetes are uric acid stones, compared to just 8-10% in the general population. These stones form in acidic urine, which is common with diabetes.

Struvite stones develop in response to certain urinary tract infections. While not directly caused by diabetes, people with diabetes have a higher risk of UTIs due to elevated glucose levels in their urine. Learn about what causes UTIs.

Cystine stones are rare and typically related to a genetic disorder. There's no direct connection between these stones and diabetes.

Your healthcare provider can determine which type of stone you have through laboratory analysis, which is crucial for developing the right prevention strategy.

For insights into kidney health, explore our Kidney Health Guide.

Warning signs that you might have kidney stones

Recognizing kidney stone symptoms early can help you get treatment before complications develop. Here's what to watch for:

Pain that comes in waves. The most common symptom is severe pain that typically starts in your back or side just below your ribs. This pain may travel to your lower abdomen and groin area as the stone moves through your urinary tract.

Changes in your urine. You might notice:

• Pink, red, or brown urine (indicating blood)

• Cloudy or strong-smelling urine

• A burning sensation when you urinate

• Needing to urinate more often than usual

• Only passing small amounts of urine despite feeling urgency

To understand more about urine color and its implications, read what urine color tells you.

Nausea and vomiting. These symptoms often accompany severe kidney stone pain.

Fever and chills. If you develop an infection along with kidney stones, you might experience fever and chills. This requires immediate medical attention.

If you have diabetes and experience any of these symptoms, contact your healthcare provider right away. Sometimes the pain from kidney stones can trigger stress-related blood sugar fluctuations, making your diabetes more difficult to manage.

Some people, especially those with diabetic neuropathy, might experience milder pain due to nerve damage. Don't dismiss unusual symptoms even if they don't match the typical kidney stone description.

How your doctor will find and treat kidney stones

If your healthcare provider suspects you have kidney stones, they'll likely recommend:

Imaging tests to confirm the diagnosis. Options include:

• CT scans, which can detect most kidney stones with high accuracy

• Ultrasound, which is often used for monitoring stones over time

• X-rays, which may be used for certain types of stones

Laboratory tests to help identify underlying causes:

• Urinalysis to check for blood, signs of infection, and crystal-forming substances

• Blood tests to assess kidney function and check levels of certain minerals

• 24-hour urine collection to measure levels of stone-forming substances

For guidance on 24-hour urine collection, refer to our article on How to Do It Properly.

If you pass a stone, your doctor may ask you to collect it for analysis. This helps determine the type of stone and guides prevention strategies.

Treatment options vary depending on the size and location of your stones:

For small stones (less than 5mm), your doctor might recommend drinking plenty of water and taking pain relievers while waiting for the stone to pass naturally.

For larger stones or those causing complications, treatments may include:

• Medications to help relax the ureter and make it easier for stones to pass

• Sound wave therapy (lithotripsy) to break up stones into smaller pieces

• Minimally invasive procedures to remove or break up stones

• Surgery for very large stones or complicated cases

If you have diabetes, your healthcare team will carefully monitor your blood sugar levels during treatment, especially if surgery is needed. Some pain medications may affect your blood sugar, so be sure to check your levels more frequently during kidney stone episodes.

How to prevent kidney stones when you have diabetes

The good news is that you can take steps to reduce your risk of developing kidney stones, even with diabetes. Here's how:

Keep your blood sugar in target range. This is the foundation of kidney stone prevention for people with diabetes. Research shows that maintaining good glucose control significantly reduces your kidney stone risk. Work with your healthcare provider to:

• Follow your medication plan carefully

• Monitor your blood sugar regularly

• Maintain a consistent carbohydrate intake

• Exercise regularly

Learn about blood sugar monitoring.

Drink plenty of fluids. Staying well-hydrated dilutes stone-forming substances in your urine. Aim for about 8-10 cups (2-2.5 liters) of water daily. If you're physically active or live in a hot climate, you may need even more. Understand the signs of dehydration.

Follow a kidney-friendly diet. Dietary recommendations may vary based on your stone type, but generally include:

• Limiting sodium to less than 2,300 mg daily

• Moderating animal protein consumption

• Including calcium-rich foods in your diet (contrary to popular belief, dietary calcium can help prevent stones)

• Limiting oxalate-rich foods if you form calcium oxalate stones

• Adding citrus fruits to your diet, as they contain citrate that helps prevent stone formation

Maintain a healthy weight. Losing excess weight can reduce insulin resistance and lower your stone risk. A study in the Journal of the American Society of Nephrology found that weight loss interventions reduced kidney stone risk by approximately 40% in overweight individuals.

Talk to your doctor about medications. Certain medications can help prevent recurrent stones:

• Thiazide diuretics can reduce calcium in urine

• Allopurinol can lower uric acid levels

• Potassium citrate can make urine less acidic

Remember to discuss any dietary changes with your healthcare provider, as some recommendations for preventing kidney stones might affect your diabetes management.

For comprehensive kidney health monitoring, consider our guide on At-Home Kidney Function Tests.

Complications to watch for when you have both conditions

Having both diabetes and kidney stones can sometimes lead to additional health challenges that you should be aware of, like a higher risk of UTIs, increased chance of kidney damage, blood sugar management problems during stone episodes, medication interactions, and a greater risk of dehydration.

Urinary tract infections (UTIs) are more common in people with diabetes, and having kidney stones increases this risk further. Signs of a UTI include cloudy urine, a strong odor, burning during urination, and fever. Contact your healthcare provider immediately if you suspect an infection. Recognize UTI symptoms.

Kidney damage can result from large, untreated stones that block urine flow. This is particularly concerning if you already have diabetic kidney disease. Regular kidney function tests are important for monitoring your kidney health.

Blood sugar management challenges often arise during kidney stone episodes. Pain and stress can raise blood sugar levels, while nausea and vomiting might make it difficult to eat normally or take medications. Have a sick day plan ready in case kidney stones affect your diabetes management.

Medication interactions can occur between treatments for kidney stones and diabetes. Always inform all your healthcare providers about all medications you're taking to avoid potential interactions.

Dehydration risk increases when you have kidney stones, especially if you experience vomiting. Dehydration can affect your blood sugar levels and make kidney stones worse. If you can't keep fluids down, seek medical help.

Regular check-ups with both your endocrinologist and urologist can help catch potential complications early.

Creating your kidney stone prevention plan

Managing both diabetes and kidney stone risk requires a coordinated approach. Here's how to create an effective prevention plan:

Work with a healthcare team that understands the connection between these conditions. Your team might include:

• Primary care physician

• Endocrinologist

• Urologist or nephrologist

• Dietitian

• Diabetes educator

Develop personalized strategies based on your specific situation. What works for one person may not work for another. If you've had kidney stones before, your prevention plan should address the specific type of stone you formed.

Monitor both conditions regularly. This includes:

• Checking blood sugar levels as recommended by your healthcare provider

• Getting regular kidney function tests

• Following up on imaging if you've had stones previously

• Tracking your fluid intake

Create a daily routine that supports both diabetes management and kidney stone prevention:

• Set reminders to drink water throughout the day

• Plan meals that work for both conditions

• Schedule regular physical activity

• Take medications as prescribed

Remember that prevention is ongoing. Even after successfully passing or treating a kidney stone, continue following your prevention plan to reduce the risk of recurrence.

Conclusion: Taking control of your health

The link between diabetes and kidney stones is clear, but having diabetes doesn't mean kidney stones are inevitable. By understanding how these conditions connect and taking proactive steps, you can significantly reduce your risk.

Many of the strategies that help manage diabetes, like staying hydrated, maintaining a healthy weight, and eating a balanced diet, also help prevent kidney stones. By focusing on these healthy habits, you're protecting your health in multiple ways.

If you've already experienced kidney stones, work closely with your healthcare team to prevent future episodes. With the right approach, you can manage both conditions successfully and maintain your quality of life.

Remember: You're not alone in managing these health challenges. Support groups, both online and in-person, can connect you with others facing similar situations and provide valuable tips and encouragement.

Want to learn more about monitoring your kidney health at home? Check out Ribbon Checkup's at-home kidney function test, which can help you track important markers between doctor visits.

Frequently Asked Questions (FAQs)

1. Does diabetes increase the risk of kidney stones?

Yes, research shows that type 2 diabetes more than doubles the risk of developing kidney stones. This is due to changes in urine acidity, dehydration, and insulin resistance.

2. Why are uric acid stones more common in diabetics?

People with diabetes often have more acidic urine, which promotes the formation of uric acid stones. Studies show around 40% of kidney stones in diabetics are uric acid-based.

3. Can controlling blood sugar prevent kidney stones?

Absolutely. Keeping blood sugar levels in your target range helps reduce urine acidity and dehydration, both of which are major contributors to kidney stone formation.

4. What are the early warning signs of kidney stones?

Common symptoms include severe back or stomach pain, nausea, vomiting, blood in the urine, frequent urination, and cloudy or foul-smelling urine.

5. How are kidney stones diagnosed in people with diabetes?

Doctors typically use imaging tests like CT scans or ultrasounds along with urine and blood tests to assess kidney function and identify stone-forming substances.

6. What lifestyle changes help prevent kidney stones in diabetics?

Staying well-hydrated, eating a kidney-friendly diet, managing blood sugar levels, maintaining a healthy weight, and limiting sodium and animal protein intake are key.

7. Are kidney stones more dangerous for people with diabetes?

Yes. Complications such as infections, kidney damage, and blood sugar spikes can occur more easily in diabetics with kidney stones, so prompt treatment is important.

8. Can medication help prevent kidney stones in diabetics?

Yes. Medications like thiazide diuretics, allopurinol, or potassium citrate may be prescribed to lower calcium or uric acid levels in the urine.

9. How does dehydration from diabetes cause kidney stones?

Frequent urination due to high blood sugar leads to fluid loss. Without adequate hydration, urine becomes concentrated, making it easier for stones to form.

10. Can I monitor kidney health at home?

Yes. At-home kidney function tests, such as urine protein or creatinine level strips, can help monitor your kidney health between doctor visits.

Related Resources

• Urine Glucose Levels Chart: Understanding Results
   Get a clear visual breakdown of what your urine glucose levels mean and how to interpret them.
  

• How to Reverse Kidney Damage from Diabetes
   Discover science-backed ways to slow or potentially reverse diabetes-related kidney damage.
  

• Urine Protein Test Strips: How to Use Them
  A step-by-step guide to using test strips for early kidney issue detection at home.

Written by Abel Tamirat, MD
Dr. Abel Tamirat is a licensed General Practitioner and ECFMG-certified international medical graduate with over three years of experience supporting U.S.-based telehealth and primary care practices. As a freelance medical writer and Virtual Clinical Support Specialist, he blends frontline clinical expertise with a passion for health technology and evidence-based content. He is also a contributor to Continuing Medical Education (CME) programs.

References

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• Kyriaki Stamatelou, & Goldfarb, D. S. (2023). Epidemiology of Kidney Stones. Healthcare, 11(3), 424–424. https://doi.org/10.3390/healthcare11030424 
• Prochaska, M., Adeola, G., Vetter, N., Mirmira, R. G., Coe, F., & Worcester, E. (2024). Insulin Resistance in Hypercalciuric Calcium Kidney Stone Patients. Kidney Medicine, 6(12), 100922–100922. https://doi.org/10.1016/j.xkme.2024.100922 
• Rajendra Nerli, Mallikarjuna Jali, AjayKumar Guntaka, Pravin Patne, Patil, S., & Hiremath, M. (2015). Type 2 diabetes mellitus and renal stones. Advanced Biomedical Research, 4(1), 180–180. https://doi.org/10.4103/2277-9175.164012 
• Sakhaee, K., & Maalouf, N. M. (2008). Metabolic Syndrome and Uric Acid Nephrolithiasis. Seminars in Nephrology, 28(2), 174–180. https://doi.org/10.1016/j.semnephrol.2008.01.010 
• Weinberg, A. E., Patel, C. J., Chertow, G. M., & Leppert, J. T. (2013). Diabetic Severity and Risk of Kidney Stone Disease. European Urology, 65(1), 242–247. https://doi.org/10.1016/j.eururo.2013.03.026