Medical Conditions That Can Raise Kidney Stone Risk
We talk a lot about diet and fluids when it comes to preventing kidney stones (because they matter!), but many people don’t realize that certain medical conditions can also make stones more likely.
If you have any of the conditions below, it doesn’t mean you’re guaranteed to get a stone—but it does mean you should be extra mindful about prevention.
Let’s take a deeper look.
1. Obesity
Carrying extra weight can change the way your kidneys filter waste. Obesity can raise the levels of stone-forming substances like calcium, oxalate, and uric acid in your urine.
People who are overweight may also be more likely to have insulin resistance, which can make urine more acidic—a setting where stones love to grow.
What to do: Even modest weight loss can help lower risk. Staying hydrated and following the Kidney Stone Diet® is key.
2. High Blood Pressure (Hypertension)
High blood pressure doesn’t just affect your heart—it also puts stress on your kidneys. Over time, this can damage kidney function and cause more calcium to spill into your urine.
That extra calcium can bind with other substances and form stones.
What to do: Keep your blood pressure under control, and be cautious with added salt (a big driver of both stones and high blood pressure).
3. Diabetes
When blood sugar is poorly controlled, your kidneys may release more acid into your urine. This can lead to uric acid stones, especially if your urine is also concentrated (not peeing enough).
People with diabetes may also have higher oxalate levels and more inflammation in the body, which raises stone risk even more.
Here is why people with diabetes may have higher oxalate levels than non diabetics:
A. Blood sugar affects how your kidneys filter waste.
When blood sugar is too high, it can damage the small filtering units in the kidneys. This can change how substances like oxalate are handled, causing more oxalate in the urine.
B. Insulin resistance may also play a role.
Many people with type 2 diabetes have insulin resistance, which is linked to more acidic urine and possibly increased oxalate production in the body.
C. Some dietary changes may increase oxalate levels.
For example, if someone with diabetes avoids carbs and loads up on high-oxalate foods like spinach, almonds, and beets, that can also increase oxalate levels. I cannot tell you how common this is in my practice enough for me to write a separate article.
What to do: Managing blood sugar, exercising, and staying within the Kidney Stone Diet® goals (most of the time) can help.
4. Inflammatory Bowel Disease (Crohn’s, Ulcerative Colitis)
These conditions affect how your body absorbs nutrients. When digestion is off, your gut may absorb too much oxalate, which then ends up in your urine and forms calcium oxalate stones.
These patients also lose more fluids, concentrating the urine (supersaturation) and giving stones a better chance to form. If you have a lot of loose stool, you tend to produce less urine.
Another common thing I see in urine collections is that bowel patients will have lower urine pH and citrate.
What to do: Work with your doctor on managing symptoms and drink plenty of fluids. Be mindful of oxalate intake, especially during flare-ups.
5. Chronic Diarrhea
When you lose fluids often through diarrhea, your body becomes dehydrated. This makes your urine more concentrated, making it easier for minerals to clump together into stones.
You may also lose substances like citrate, which normally helps prevent stones.
What to do: Hydration is critical. Your doctor may recommend fluids with electrolytes and citrate-based treatments if needed.
6. Bowel Surgery
(Including colon resection, small intestine surgery, or weight loss surgery)
These surgeries can change how your gut absorbs nutrients. After surgery, your body may absorb more oxalate, especially if fat digestion is altered. You may also lose more fluids.
That one-two punch—more oxalate, less urine volume—creates the perfect storm for stones.
What to do: Ask your doctor for a urine test to monitor oxalate levels. Stay hydrated and get enough dietary calcium to lower oxalate absorption.
7. Thyroid Disease (Hyperthyroidism)
Too much thyroid hormone speeds everything up—including how quickly your body breaks down bone. That can release extra calcium into your blood and urine, making calcium stones more likely.
What to do: Make sure your thyroid levels are well-managed. If you’ve had hyperthyroidism, ask your doctor if a 24-hour urine test is right for you.
8. Parathyroid Disease (Primary Hyperparathyroidism)
This condition causes your body to make too much parathyroid hormone, which pulls calcium out of your bones and sends it into your bloodstream—and into your urine.
That extra calcium can form calcium-based stones, and many people with PHPT don’t even know they have it. This is just one of the reasons I scream every day to anyone that will listen to me to ask your doctor to order you a 24-hour urine collection.
What to do: If your urine calcium is high, ask your doctor to check your blood calcium and PTH levels—even if they’ve been “normal” before.
9. Renal Tubular Acidosis (RTA)
This is a condition where the kidneys don’t properly balance acid in your body. Your urine is too alkaline (this will show as a high urine pH on your urine collection results), creating an environment where calcium phosphate stones can easily form.
What to do: RTA is treatable. Doctors often prescribe potassium citrate to help restore balance and lower stone risk.
10. Medullary Sponge Kidney
This is a condition you’re born with. Tiny pockets form in the kidney where urine can get “stuck.” When urine sits around too long, minerals like calcium and phosphate can settle and form stones.
What to do: Regular monitoring and urine testing are important. Staying well-hydrated helps flush the kidneys more often and of course following the Kidney Stone Diet®.
11. Gout
Gout causes too much uric acid to build up in the body. Some of that uric acid ends up in your urine, where it can form uric acid stones, especially if your urine is too acidic.
What to do: Gout meds can help, and so can drinking more water. Talk to your doctor about how to manage uric acid levels safely.
12. Osteoporosis / Osteopenia
When bones get weak, they lose calcium—and that calcium ends up in the urine. The more calcium in your pee, the more chance of stone formation.
What to do: Don’t skimp on calcium from food! Getting the right amount of calcium helps bind oxalate in the gut and protects your bones and kidneys.
13. Neurogenic Bladder
When nerves don’t tell the bladder to empty properly, urine can sit too long. This gives minerals in the urine time to settle and form stones.
What to do: Your doctor may recommend ways to help your bladder empty more often. Staying hydrated and avoiding urinary infections helps, too.
14. Recurrent Urinary Tract Infections (UTIs)
Some bacteria, especially those causing chronic infections, can change the chemistry of your urine. This can lead to large, fast-growing struvite stones.
What to do: Preventing and treating infections quickly is key. If you get UTIs often, your doctor may want to screen you for stones.
15. Cancer
Cancer—and some cancer treatments—can break down body tissues quickly, releasing things like calcium or uric acid into the blood. That extra waste ends up in the urine and may form stones.
What to do: Your doctor will monitor your labs closely. If you’re a cancer patient, make sure kidney stone risk is part of your care plan.
16. Eating Disorders (Anorexia, Bulimia)
These conditions often lead to dehydration, poor nutrition, and low bodyweight, which throw off your body’s balance. You may have concentrated urine and changes in minerals like calcium and oxalate—all of which raise stone risk.
What to do: Gentle medical nutrition support from an expert in eating disorders and rehydration can lower stone risk. Recovery is possible—and so is prevention.
Final Thoughts
If you have one or more of these conditions, kidney stone prevention is extra important.
The good news? You can still lower your risk by following the Kidney Stone Diet®, drinking plenty of water, and asking your doctor for a 24-hour urine test to learn what your body is doing.
If you need help understanding your 24-hour urine collection results before you see your doctor, I am an expert in breaking them down so you can have a better doctor’s office visit!
Knowledge is power.
Your friend,
Nurse Jill
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