Kidney Stones: Why They Form and When the Pain Needs Medical Attention

A sudden, severe pain in one side of the back or flank that travels toward the lower abdomen or groin can be a sign of a kidney stone. The pain may come in waves and may be accompanied by nausea, vomiting, urinary symptoms or blood in the urine.

Hot weather and dehydration can also matter. When the body loses fluid through sweating and that fluid is not adequately replaced, urine becomes more concentrated. This can make it easier for certain minerals and salts to crystallise in people who are prone to kidney stones.

But not every episode of back pain is caused by the kidneys, and not every kidney stone requires surgery. The important questions are where the pain is located, whether urinary symptoms are present, whether there is infection or obstruction, and whether imaging or urgent treatment is needed.

Medical review: This article has been reviewed by doctors at DRFK Turkish International Day Surgery Center for medical accuracy and general patient education.

Quick Answer: Can Dehydration Increase the Risk of Kidney Stones?

Yes. Dehydration can reduce urine volume and make urine more concentrated. When urine is concentrated, substances that contribute to stone formation have a greater opportunity to crystallise. Adequate fluid intake is therefore one of the most important preventive measures for people at risk of kidney stones.

People who sweat heavily, exercise outdoors, work in hot conditions or have had kidney stones before may need to pay particular attention to hydration.

What Are Kidney Stones?

Kidney stones are hard deposits that form when minerals and other substances in the urine crystallise.

They can vary considerably in:

• Size
• Location
• Number
• Composition
• Symptoms

A small stone may remain inside the kidney without causing any symptoms. Problems often begin when a stone moves from the kidney into the ureter, the narrow tube that carries urine toward the bladder.

This movement can produce the severe pain commonly called renal colic.

What Are the Symptoms of Kidney Stones?

Symptoms depend on where the stone is and whether it is obstructing urine flow.

Possible symptoms include:

• Severe pain in one side of the back or flank
• Pain travelling into the lower abdomen
• Pain extending toward the groin
• Pain that comes in waves
• Nausea
• Vomiting
• Blood in the urine
• Burning during urination
• Frequent urge to urinate
• Difficulty passing urine in some cases

Some small kidney stones may cause no symptoms at all and may be found incidentally during imaging.

If symptoms are new or the cause of the pain is unclear, an initial clinical assessment can help determine whether blood tests, urine testing or imaging are appropriate. DRFK also offers broader preventive health and laboratory assessment when kidney function or metabolic health needs to be reviewed in context.

What Does Kidney Stone Pain Feel Like?

Kidney stone pain can be intense.

It often starts suddenly and may be felt in the:

flank → lower abdomen → groin

The pain may become stronger and weaker in waves as the ureter contracts around the stone.

Some people also experience:

• Nausea
• Sweating
• Vomiting
• Restlessness
• Difficulty finding a comfortable position

Unlike many muscular back problems, kidney stone pain may not improve significantly when you change position.

Kidney Stone Pain vs Back Pain: How Can You Tell the Difference?

This is one of the most common questions.

Muscular or Mechanical Back Pain

It is more likely to:

• Change with movement
• Worsen with bending or twisting
• Follow lifting, exercise or prolonged sitting
• Improve with rest or a different position
• Remain centred around muscles or the lower spine

Kidney Stone Pain

It is more likely to:

• Start suddenly
• Occur on one side of the flank
• Come in waves
• Move toward the abdomen or groin
• Occur with nausea or urinary symptoms
• Be difficult to relieve by simply changing position

These differences are useful, but they are not enough to make a definite diagnosis.

If the pain is severe, new or associated with urinary changes, medical assessment is important.

Where Is Kidney Pain Usually Felt?

Kidney-related pain is often felt at the side of the back, below the ribs, rather than directly over the centre of the spine.

The location can provide useful clues.

Pain in the Centre of the Lower Back

Muscular or spinal causes may be more likely.

Pain on One Side Below the Ribs

Kidney or ureteric causes become more relevant, particularly when urinary symptoms are present.

Pain Moving Into the Lower Abdomen or Groin

This pattern can occur as a stone moves through the ureter.

Pain Clearly Triggered by Movement

This can make a musculoskeletal source more likely, although it does not completely exclude other conditions.

Does Blood in the Urine Mean You Have a Kidney Stone?

Kidney stones can cause blood in the urine.

The urine may appear:

• Pink
• Red
• Brown

Or blood may only be detected during laboratory testing.

However, blood in the urine does not automatically mean there is a kidney stone.

Other causes include:

• Urinary tract infection
• Kidney disease
• Bladder conditions
• Prostate conditions
• Other urinary tract problems

Visible or unexplained blood in the urine should therefore be medically evaluated rather than assumed to be caused by a stone.

Does Burning Urination Mean You Have a Stone?

Not necessarily.

A stone can cause urinary burning or increased urinary frequency, especially if it has moved closer to the bladder.

But burning during urination is also commonly associated with urinary tract infection.

If urinary burning occurs with:

• Fever
• Chills
• Cloudy urine
• Significant flank pain
• General illness

infection needs to be considered.

Kidney Stone or Kidney Infection: Why Does the Difference Matter?

A kidney stone can cause severe pain without infection.

A kidney infection may be accompanied by:

• Fever
• Chills
• Flank pain
• Nausea
• Vomiting
• Feeling significantly unwell
• Urinary symptoms

The situation becomes more concerning when a stone obstructs urine flow and infection is present at the same time.

An infected, obstructed urinary system can require urgent treatment.

When Is a Kidney Stone an Emergency?

Seek urgent medical assessment if kidney stone-type pain occurs with:

• Fever or chills
• Persistent vomiting
• Inability to drink fluids
• Inability or major difficulty urinating
• Severe uncontrolled pain
• Marked weakness or dizziness
• Rapid deterioration
• A single functioning kidney
• Pregnancy with significant flank pain

These symptoms should not be managed simply by drinking more water at home.

Why Does Dehydration Increase the Risk of Kidney Stones?

When the body is well hydrated, urine is more diluted.

When fluid losses are not replaced:

• Urine volume falls
• Mineral concentrations rise
• Crystals may form more easily
• Existing crystals may have a greater opportunity to grow

This is why hydration is a central part of kidney stone prevention.

People who work outdoors or exercise in hot weather may lose more fluid than they realise.

What Are the Signs of Dehydration?

Possible signs include:

• Thirst
• Dry mouth
• Passing less urine
• Darker urine
• Fatigue
• Headache
• Dizziness
• Difficulty concentrating

Urine colour alone is not a perfect diagnostic tool because medications, vitamins and foods can also change urine colour.

Does Dark Urine Mean You Have Kidney Stones?

No.

Dark urine may simply mean the urine is concentrated because of reduced fluid intake.

However, urine that appears clearly red, brown or is associated with pain, fever or burning should be assessed rather than attributed to dehydration alone.

How Much Water Should You Drink to Reduce Kidney Stone Risk?

There is no single amount that is appropriate for everyone.

Fluid requirements vary according to:

• Body size
• Physical activity
• Climate
• Degree of sweating
• Age
• Pregnancy
• Medical conditions
• Medications

People with recurrent kidney stones may be advised to increase fluid intake substantially, but the target should be individualised.

People with certain kidney or heart conditions may have fluid restrictions and should not increase intake dramatically without medical guidance.

How Can You Tell Whether You Are Drinking Enough?

For many healthy adults, relatively pale urine can be a practical sign of adequate hydration, although it should not be treated as a precise medical test.

Pay closer attention to hydration if you:

• Work outdoors
• Exercise frequently
• Sweat heavily
• Spend long periods in heat
• Have previously had kidney stones

Rather than waiting until you are extremely thirsty, it is generally more practical to distribute fluid intake throughout the day.

Is It Better to Drink Water All at Once or Throughout the Day?

For most people, spreading fluid intake through the day makes more sense than becoming dehydrated for many hours and then drinking a large volume at once.

Practical habits include:

• Drinking after waking
• Keeping water available during work
• Drinking with meals
• Hydrating before and after exercise
• Replacing fluid after heavy sweating

The goal is to avoid prolonged periods of concentrated urine.

Can Drinking Water Dissolve Kidney Stones?

Water does not dissolve most existing kidney stones.

Adequate fluid intake can, however:

• Increase urine flow
• Reduce urine concentration
• Help some small stones pass
• Reduce the risk of further stones forming

A larger stone or a stone causing significant obstruction may require medical treatment.

Does Lemon Water Help Prevent Kidney Stones?

Citrus fruits contain citrate, a substance that may reduce the formation of certain types of kidney stones in some patients.

That does not mean lemon juice will dissolve an existing kidney stone or prevent every type of stone.

The usefulness of citrate depends on the type of stone and the person's urine chemistry.

Sugary lemon drinks are also not the same as using citrate strategically as part of a medically guided prevention plan.

Does Salt Increase the Risk of Kidney Stones?

High sodium intake can increase urinary calcium excretion in some people and may contribute to the formation of calcium-based kidney stones.

Common high-sodium foods include:

• Processed meats
• Fast food
• Packaged meals
• Crisps
• Sauces
• Pickled foods
• Some restaurant foods

Reducing excessive sodium may therefore be an important part of prevention for selected patients.

Should You Stop Eating Calcium If You Have Calcium Stones?

Not automatically.

A calcium-containing kidney stone does not mean dietary calcium should simply be eliminated.

In some people, excessively restricting dietary calcium may actually be counterproductive.

Dietary advice should instead be based on:

• Stone composition
• Blood results
• Urine testing
• Medical history
• Usual diet

Can Meat or High-Protein Diets Cause Kidney Stones?

A high intake of certain animal proteins may contribute to stone risk in some people, particularly where uric acid is involved.

But there is no single diet that applies to every patient with stones.

The correct approach depends on:

• Stone type
• Urine acidity
• Uric acid levels
• Sodium intake
• Calcium intake
• Oxalate exposure
• Other metabolic findings

Restrictive diets should therefore not be started without understanding the underlying stone type.

Are Soft Drinks a Problem for People With Kidney Stones?

Water should generally be the main hydration source.

Relying heavily on sugary or carbonated drinks instead of water can make daily hydration less effective and may introduce high amounts of sugar or other ingredients.

The broader dietary pattern is more important than blaming one drink in isolation.

Do Coffee and Tea Cause Kidney Stones?

Coffee and tea should not automatically be considered direct causes of kidney stones.

The more important questions are:

• How much total fluid you drink
• What type of stone you form
• What else is in your diet
• Whether the drink contains large amounts of sugar
• Your overall medical condition

Water remains the simplest primary hydration choice.

Are Energy Drinks Good for Hydration?

Energy drinks should not be used as the main replacement for water.

They may contain:

• Caffeine
• Sugar
• Sodium
• Other stimulants or additives

For routine hydration, water is usually more appropriate for most people.

Can Exercising in Hot Weather Increase Kidney Stone Risk?

Exercise itself does not cause kidney stones.

The concern is heavy sweating without adequate fluid replacement.

People who:

• Run outdoors
• Cycle
• Play football
• Perform high-intensity exercise
• Work physically outside

may need to pay more attention to hydration before, during and after activity.

Who Is More Likely to Develop Kidney Stones?

Risk may be higher in people who:

• Have had stones before
• Have a family history of kidney stones
• Drink relatively little fluid
• Have a high-sodium diet
• Have certain bowel or absorption disorders
• Have some metabolic conditions
• Take specific medications
• Sweat heavily on a regular basis

Having one risk factor does not mean a stone will definitely develop.

Why Do Kidney Stones Keep Coming Back?

Recurrent kidney stones deserve a different approach from a single isolated episode.

If stones recur, the aim should be to understand why they are forming.

Assessment may include:

• Urinalysis
• Blood tests
• Stone analysis if the stone can be collected
• Calcium testing
• Uric acid testing
• Dietary review
• Medication review
• A 24-hour urine test in selected patients

A broader Executive Health Checkup at DRFK can also assess kidney-related and metabolic markers through blood testing, urinalysis and organ-function profiling when a wider preventive evaluation is appropriate.

What Are the Main Types of Kidney Stones?

Not all kidney stones are the same.

Calcium Oxalate Stones

These are among the most common types.

Calcium Phosphate Stones

These may occur under different urine conditions and can be associated with particular medical factors.

Uric Acid Stones

These may form when urine is persistently acidic.

Struvite Stones

These can be associated with certain urinary infections.

Cystine Stones

These are less common and are associated with an inherited disorder.

Knowing the type of stone can significantly improve prevention planning.

How Are Kidney Stones Diagnosed?

Diagnosis begins with the symptoms and medical history.

Evaluation may include:

• Urine testing
• Blood tests
• Ultrasound
• CT imaging when appropriate

The goal of imaging is not simply to confirm that a stone exists.

It also helps answer:

• Where is the stone?
• How large is it?
• Is it blocking urine flow?
• Has the kidney become obstructed?
• Is another diagnosis possible?

DRFK has in-house diagnostic imaging pathways as part of its broader healthcare services. Its Full Body MRI service includes abdominal organs and kidneys in preventive structural imaging, although MRI is not the standard first-line test for an acute suspected ureteric stone.

CT Scan or Ultrasound: Which Test Is Used for Kidney Stones?

The best imaging test depends on the clinical situation.

A doctor may use:

• Ultrasound
• A CT scan
• Other imaging in selected circumstances

Factors influencing the choice include:

• Age
• Pregnancy
• Severity of symptoms
• Previous stones
• Concern for obstruction
• Need for detailed anatomical information

A CT scan can provide detailed information about stone size and location, while ultrasound may be preferred in some patients because it does not use ionising radiation.

The important point is that not every patient with flank pain needs exactly the same test.

Does Every Kidney Stone Need Surgery?

No.

Some small stones pass naturally.

Others may require:

• Pain management
• Observation
• Medication in selected cases
• Stone fragmentation
• Endoscopic stone removal
• Urgent drainage if obstruction is complicated by infection

Treatment depends on more than size alone.

Doctors also consider:

• Stone location
• Degree of obstruction
• Severity of pain
• Infection
• Kidney function
• Ability to tolerate fluids
• Individual medical circumstances

What Size Kidney Stone Can Pass Naturally?

There is no size that guarantees spontaneous passage.

The chance depends on:

• Stone size
• Stone position in the ureter
• Anatomy
• Presence of obstruction
• Severity and duration of symptoms

A smaller stone generally has a better chance of passing, but treatment decisions should not be based on millimetres alone.

How Long Does It Take to Pass a Kidney Stone?

Some stones may pass within days, while others take longer or fail to pass on their own.

During observation, the more important questions are:

• Is pain controlled?
• Is there infection?
• Is the kidney obstructed?
• Can the patient drink and urinate?
• Is kidney function preserved?

Waiting is only appropriate when it is safe to do so.

What Should You Do If You Think You Have a Kidney Stone?

If you develop symptoms suggestive of a kidney stone, pay attention to:

1. •Where the pain begins
2. •Where it travels
3. •Whether you have nausea or vomiting
4. •Whether your urine has changed
5. •Whether you have fever or chills
6. •Whether you can urinate normally

If the pain is severe, symptoms are persistent or there are signs of infection or obstruction, medical evaluation should not be delayed.

For non-emergency concerns or unexplained recurrent symptoms, you can book a medical appointment at DRFK for assessment and appropriate referral or testing.

How Can You Reduce the Risk of Kidney Stones?

Useful preventive measures may include:

• Drinking fluids regularly throughout the day
• Paying extra attention to hydration during hot weather
• Replacing fluid after heavy sweating
• Making water the main drink
• Avoiding excessive salt intake
• Not eliminating dietary calcium without a medical reason
• Avoiding extreme dietary restrictions before the stone type is known
• Investigating recurrent stones

Prevention is most effective when it is tailored to the type of stone and the individual's risk factors.

Should Recurrent Kidney Stones Be Part of a Wider Health Check?

Sometimes, yes.

Recurrent stones can be influenced by metabolic factors, kidney function, diet and other health conditions.

A broader Executive Health Checkup at DRFK includes comprehensive blood analysis, organ-function assessment and urinalysis for renal and metabolic warning signals. It can be useful when stone recurrence is part of a wider preventive health assessment rather than an isolated acute attack.

This does not replace a targeted urological evaluation when a symptomatic stone is suspected.

Frequently Asked Questions About Kidney Stones and Dehydration

Kidney stones can cause severe pain, but some remain silent until they move or are found on imaging. The following questions address the most common concerns about symptoms, hydration, testing and treatment.

Can Hot Weather Cause Kidney Stones?

Heat does not directly create a kidney stone. However, hot conditions can increase sweating and fluid loss. If those fluids are not replaced, urine becomes more concentrated and stone formation may become more likely in susceptible people.

What Is Usually the First Sign of a Kidney Stone?

A sudden, severe pain in one side of the flank is a common first symptom, particularly when the pain begins moving toward the lower abdomen or groin.

Where Is Kidney Stone Pain Felt?

Kidney stone pain commonly occurs in the flank, below the ribs, and may travel toward the lower abdomen or groin.

How Can I Tell Kidney Pain From Back Pain?

Kidney stone pain is often sudden, wave-like and may occur with nausea, urinary symptoms or blood in the urine. Muscular back pain is more likely to change significantly with movement or position.

Can Drinking Water Get Rid of a Kidney Stone?

Adequate fluid intake may help some small stones pass, but water does not dissolve most established kidney stones and cannot treat a significant obstruction.

Is Lemon Water Good for Kidney Stones?

Citrate in citrus fruits may help reduce formation of certain stones in selected people, but lemon water is not a treatment for every type of kidney stone.

Can You Have a Kidney Stone Without Pain?

Yes. Some stones remain inside the kidney and produce no symptoms.

Does Blood in the Urine Always Mean a Kidney Stone?

No. Stones are one possible cause, but infections and other urinary tract conditions can also cause blood in the urine.

Can a Kidney Stone Cause Fever?

A simple stone does not necessarily cause fever. Fever or chills in someone with suspected kidney stones raises concern about infection and should be assessed promptly.

Does Every Kidney Stone Require Surgery?

No. Many smaller stones can pass spontaneously, while others require intervention depending on size, location, obstruction, infection and symptoms.

When Should I Go to the Emergency Department?

Seek urgent care if severe flank pain occurs with fever, chills, persistent vomiting, inability to urinate, marked weakness or rapid deterioration.

What Should You Remember About Kidney Stones and Dehydration?

Kidney stones are not caused by one factor alone, but dehydration can make urine more concentrated and increase stone-forming conditions in people who are susceptible.

If you have previously had stones, work in hot conditions or sweat heavily, regular hydration becomes especially important.

But prevention should not focus on water alone.

Ask:

Do I have recurrent stones? Is my diet high in sodium? Has my stone type ever been analysed? Do I have metabolic or kidney-related risk factors?

And if you develop:

severe flank pain + blood in the urine + fever + vomiting + difficulty urinating

do not treat the episode as simple dehydration.

The key questions are:

Is there a stone? Where is it? Is it obstructing the urinary tract? Is there infection? And does it need urgent treatment?

For non-emergency symptoms, recurrent kidney stone concerns or a broader review of kidney and metabolic health, you can book an appointment at DRFK Turkish International Day Surgery Center or explore the Executive Health Checkup for structured preventive laboratory and organ-function assessment.