Kidney stone causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]
Overview
Overview
The common causes of nephrolithiasis include hypercalcemia, hyperparathyroidism, hypercalciuria, infection with urea splitting microorganisms like Proteus and Pseudomonas, gout, dehydration, inflammatory bowel disease. Less common causes of nephrolithiasis include drugs such as loop diuretics, Acetazolamide, ciprofloxacin, indinavir, guaifenesin triamterene and magnesium trisilicate.
Causes
Causes
Common Causes
The common causes of nephrolithiasis:
- Hypercalcemia
- Hypercalciuria
- Infection with urea splitting microorganisms like Proteus and Pseudomonas
- Gout
- Dehydration
- Inflammatory bowel disease
Less Common Causes
Less common causes of nephrolithiasis include:
- Drugs:
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Ciprofloxacin, Cobicistat, Febuxostat, Guaifenesin, Indinavir, Ixabepilone, Loop diuretics, Magnesium trisilicate Oxcarbazepine, Pramipexole, Sulfasalazine, Tocilizumab, Topiramate,Triamterene, Zonisamide |
| Ear Nose Throat | No underlying causes |
| Endocrine | hyperparathyroidism, hypoparathyroidism, Diabetes mellitus |
| Environmental | No underlying causes |
| Gastroenterologic | Short bowel syndrome, Inflammatory bowel disease, Increased intestinal absorption of oxalates, Chronic Malabsorption syndrome |
| Genetic | X-linked recessive nephrolithiasis type 1, X-linked hypophosphataemia, Adenine phosphoribosyltransferase deficiency |
| Hematologic | Leukemia |
| Iatrogenic | No underlying causes |
| Infectious Disease | Urinary tract infection, Pseudomonas, Proteus, Klebsiella, Infection with urea splitting microorganisms, Berylliosis |
| Musculoskeletal/Orthopedic | Paget’s Disease |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | Xanthinuria type 2, Xanthinuria type 1, Primary type 1 Hyperoxaluria, Lower Dietarypotassium, Lower Dietary phytate, Lower dietary calcium, Hypervitaminosis D, Higher Dietary vitamin C, Higher Dietary sucrose, Higher Dietary sodium, Higher Dietary oxalate, Higher Dietary fructose, Higher Dietary animal protein, Excessive Vitamin C intake |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | Tumor hypercalcemia, Bone metastasis, Leukemia |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | Alcohol abuse |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | Urine PH less than 5.5, Type I (distal) renal tubular acidosis, Primary Hypokalaemic distal renal tubular acidosis , Medullary sponge kidney, Lower Urinary volume, Lower Urinary citrate, Hypophosphaturia, Hypocitraturia, Hyperuricosuria, Hyperuricemia , Hyperoxaluria, Hypercalciuria, Hypercalcemia, Horseshoe kidney, Higher Urinary pH (CaP stones), Higher Urinary oxalate (CaOx stones), Higher Urinary calcium, Distal (type 1) renal tubular acidosis, Cysteinuria, Chronic metabolic acidosis, Hyperoxaluria |
| Rheumatology/Immunology/Allergy | Sarcoidosis, Gout |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | Urinary stasis, Urinary obstruction |
| Miscellaneous | Supersaturatin of stone forming compunds in urine, Presence of nidus for crystal precipitation, Obesity, Milk-alkali syndrome, Lower fluid intake, Lesch-Nyhan syndrome, Idiopathic, Dent’s disease, Dehydration |
Causes in Alphabetical Order
Causes based on type of Stones
Calcium Stones
- Bone metastasis
- Cushing’s syndrome
- Distal renal tubular acidosis
- Excessive Vitamin C intake
- Hypercalcemia
- Hyperthyroidism
- Hyperoxaluria
- Hyperuricosuria
- Hypophosphaturia
- Idiopathic hypercalciuria
- Increased intestinal absorption of oxalates
- Leukemia
- Milk-alkali syndrome
- Osteoporosis
- Paget’s Disease
- Sarcoidosis
- Tumor hypercalcemias
- Hypervitaminosis D
Infectious Stones
Uric Acid Stones
- Alcohol abuse
- Dehydration
- Drugs
- Gout
- Purine metabolism
- Tumor
- Idiopathic
Congenital Stones
Genetic Causes
Metabolic imbalances lead to urine crystallization and defective genes that normally encode proteins that maintain metabolic balance causes heritable forms of nephrolithiasis, sometimes leading to CKD.
- Genetic forms of kidney stone disease include adenine phosphoribosyltransferase deficiency, Dent’s disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis, and primary hyperoxaluria, frequently lead to CKD and progress to kidney failure.
- These patients have the risk of recurrence after a transplantation as it doesnot address the underlying metabolic imbalance.
Syndromes like monogenic diabetes, monogenic hyperlipidemia or hypertension, and monogenic systemic lupus erythematosus are known to cause secondary kidney damage.
References
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