Gout and Kidney Stones: What's the Connection?
Uric Acid, Stone Risk and When to Get Help
Gout and kidney stones can be linked through uric acid, but most kidney stones aren't caused by gout, and having gout doesn't mean you'll get a stone.
Yes, they can be linked. Uric acid is the common thread: people with gout may be more likely to form a particular type called uric acid stones. But most kidney stones are not uric acid stones, having gout doesn't mean you will get one, and having a stone doesn't mean you have gout. Severe pain in your side or back, especially with a fever, needs urgent medical help.
How Are Gout, Uric Acid and Kidney Stones Linked?
Gout happens when too much uric acid in the blood forms tiny crystals in and around a joint (see our guide to uric acid and gout). Kidney stones are different: they are hard deposits that form inside the kidneys or the tubes that drain them, when waste chemicals in the urine crystallise. The NHS says stones are common, affecting more than 1 in 10 people at some point.
Uric acid is part of both stories. Your kidneys filter it out and it leaves the body in urine. In some people, urine carries a lot of uric acid, is persistently acidic, or is very concentrated, and uric acid crystals can then clump together into a stone. The crystals in a gouty joint and a uric acid stone are separate problems in separate parts of the body, so one doesn't automatically cause the other.
The link is an association, not a rule. Plenty of people have gout without ever having a stone, and most people with kidney stones don't have gout. For the wider picture of why urate builds up, see what causes gout.
Uric Acid Stones vs Other Kidney Stones
Not all kidney stones are caused by uric acid. The NHS describes three main types: calcium stones (the most common), struvite stones (usually caused by infection) and uric acid stones (usually caused by a large amount of acid in the urine). Knowing which type you have matters, because prevention advice depends on it.
| Stone type | Usually linked to | Connection with gout |
|---|---|---|
| Calcium stones | The most common type, according to the NHS | Not caused by gout, though someone with gout can still get one |
| Uric acid stones | A large amount of acid in the urine, often with concentrated urine | The type most connected with gout and high uric acid |
| Struvite stones | Usually a urine infection, according to the NHS | No direct link |
| Rarer types | Various causes | Not typically related to gout |
Uric acid stones may not show up clearly on a plain X-ray but can be seen on a CT scan. If you pass a stone, keeping it for analysis can help your doctor work out what kind it is, and NICE says stone analysis should be considered for adults with kidney or ureteric stones.
Does Having Gout Mean You Will Get Kidney Stones?
No. Gout may raise the chance of uric acid stones in some people, but many people with gout never develop a stone. Whether one forms depends on several things at once, not just your blood uric acid level.
- Not drinking enough fluid, which makes urine more concentrated. The NHS lists this as a significant risk factor.
- Urine with a large amount of acid in it, which is how uric acid stones tend to form.
- High uric acid levels in the blood or urine.
- Overweight, type 2 diabetes and related metabolic conditions, which medical literature links with uric acid stones.
- A previous stone or a family history of stones, both listed by the NHS as risk factors for stones coming back.
- Some medicines. The NHS names diuretics ("water tablets") and aspirin among those that can raise the chance of stones returning in people who are prone to them.
Don't stop or change any prescribed medicine yourself if you're worried about this. Raise it with your GP, pharmacist or specialist, who can weigh it against the reason you take it.
Kidney Stone Symptoms
Small stones can pass without you noticing. Larger ones can cause severe pain in the side of your tummy or your back, which often comes and goes in waves, along with feeling or being sick. You may also notice blood in your urine.
This is different from a gout attack, which causes a hot, swollen, red, painful joint. Kidney stone pain is felt in the side, back or tummy rather than in a joint. If you're not sure what's causing your pain, don't try to work it out yourself; ask a clinician.
When Kidney Stone Symptoms Need Urgent Attention
You have severe pain in your side, back or tummy together with a high temperature, chills or feeling shivery; you have severe pain that isn't settling; you're being sick and can't keep fluids down; or you notice blood in your urine. A stone with infection can become serious quickly. In the UK, contact your GP urgently or call NHS 111. If you feel very unwell or can't get urgent advice, go to A&E or call 999.
How Are Kidney Stones Diagnosed?
According to the NHS, a GP may arrange urine tests (to look for infection and small pieces of stone), blood tests (to check how well your kidneys are working and the levels of certain substances), and an examination of any stone you pass. If you have severe pain, you may be sent to hospital for an urgent scan. NICE recommends urgent low-dose CT for adults with suspected renal colic; the NHS says ultrasound is used instead in pregnancy and for children.
If you have gout, tell the clinician, and bring any recent urate results. Our uric acid levels chart explains what the numbers mean, though your own results should always be interpreted by your doctor.
Kidney Stone Treatment: An Overview
Most stones are small enough to pass in your urine. The NHS says this can take a few weeks, with pain relief such as an NSAID (for example ibuprofen), plenty of fluids and, if needed, anti-sickness medicine. NICE lists NSAIDs as first-line pain relief, and says a medicine called an alpha blocker can be considered to help some smaller stones pass. NSAIDs aren't suitable for everyone, so check with a pharmacist or doctor.
Stones that are too large to pass, or that cause severe pain or complications, are treated in hospital. Options include shockwave lithotripsy, ureteroscopy and percutaneous nephrolithotomy. A specialist will explain which suits your stone.
Uric acid stones are a special case. Because they form in acidic urine, a specialist may sometimes use medicines that make urine less acidic, or consider urate-lowering treatment, as part of a plan. That is decided case by case, so don't try to change your urine acidity or your medicines yourself.
Drinking Enough and Other Ways to Reduce Risk
The NHS advice is to drink plenty of water every day so you don't become dehydrated, and to keep your urine pale. Tea and coffee count towards your fluids, and you may need more in hot weather or when exercising. NHS and NICE stone-prevention advice mentions fluid intakes of around 2.5 to 3 litres a day, but the right amount varies. It may be different if you have a heart or kidney condition or have been told to limit fluids, so ask your clinician what suits you. Pale urine is a useful everyday guide. We cover this more in hydration and gout.
The NHS also advises not eating too much salt, and says not to make major diet changes without speaking to your doctor first, because the right advice depends on the type of stone. There isn't a single food or diet proven to dissolve stones or guarantee they won't return, so be wary of any product that claims otherwise. Avoid crash diets, which can be unhelpful for gout as well.
Managing Gout and Urate Alongside Stone Risk
Gout and stones are managed together, not as one problem. Treating gout doesn't automatically prevent stones, and treating a stone doesn't treat gout. If you take urate-lowering medicine, keep taking it as prescribed and tell your clinician if you develop a stone. See our gout treatment guide for how these medicines work in general.
NICE advises offering urate-lowering treatment to people with certain patterns of gout and aiming for a blood urate below 360 micromol/litre for most people on treatment. Your kidney function is one of the things a clinician considers when choosing and dosing gout medicines, so a history of stones or kidney problems is worth mentioning at every review.
When to Speak to Your GP
- You've had symptoms that could be a kidney stone, such as pain in your side or back that comes and goes.
- You've had a kidney stone before and think you may have another.
- You have gout and stones, or a family history of stones, and want to talk about prevention.
- You notice blood in your urine.
- You take medicines such as diuretics or aspirin and are worried about stone risk (don't stop them yourself).
- Your gout attacks keep returning despite treatment. See recurrent gout.
Frequently Asked Questions
Can gout cause kidney stones?
Gout and kidney stones can be linked through uric acid, and people with gout may be more likely to form uric acid stones. But gout doesn't directly cause every stone, and most people with gout never develop one.
Can high uric acid cause kidney stones?
It can contribute, mainly to uric acid stones. Whether a stone forms also depends on how acidic and concentrated your urine is, so high blood uric acid on its own doesn't guarantee a stone.
Are all kidney stones caused by uric acid?
No. The NHS says calcium stones are the most common type. Uric acid stones are one of several types, and struvite stones are usually caused by infection.
Can kidney stones cause gout?
No. A kidney stone doesn't cause gout. They are separate conditions that can share some risk factors, such as dehydration and metabolic conditions.
Can I dissolve uric acid stones at home?
Not safely on your own. Specialists sometimes use medicines to make urine less acidic, but that needs medical supervision. Avoid products that claim to dissolve stones, and ask your GP if you're concerned.
Do my gout medicines cause kidney stones?
Gout medicines are prescribed for good reasons, so don't stop them yourself. The NHS does list some medicines, including diuretics and aspirin, as raising the chance of stones returning in people who are prone to them. Ask your pharmacist or doctor to review your medicines.
Does drinking more water help both gout and stones?
The NHS advises staying hydrated to help prevent both gout attacks and kidney stones. How much you need varies, so ask your clinician if you have a heart or kidney condition or a fluid limit.
How can I tell kidney stone pain from a gout attack?
Gout typically affects a joint, which becomes hot, swollen and red. Kidney stone pain is usually felt in the side, back or tummy and comes in waves. If you have a fever, feel very unwell or aren't sure, get medical advice promptly.
Related Reading
Uric Acid and Gout
How uric acid builds up, what it does in the body and how it relates to gout.
Read guide →What Causes Gout?
The main causes and risk factors behind high uric acid and gout attacks.
Read guide →Hydration and Gout
How fluids fit into gout care, and what to consider about how much to drink.
Read guide →This guide is for general educational purposes and is not personal medical advice. It cannot tell you whether your symptoms are caused by gout, a kidney stone or something else. Severe pain, fever, blood in your urine or feeling very unwell need prompt medical assessment. Always speak with your doctor, pharmacist or a registered dietitian before changing any medicine, fluid intake or diet, especially if you take medication for gout or have kidney or heart conditions.