Does a nephrologist or a urologist treat kidney stones?

Both, in different ways. A urologist treats the stone itself — removing or breaking up stones that won't pass. A nephrologist focuses on why the stones are forming and how to prevent new ones, often with a metabolic evaluation. For a one-time stone that passes easily, a urologist or your primary care doctor may be all you need; for recurrent stones, both roles matter and the two work together.

What is the main cause of kidney stones?

For most people the biggest single factor is not drinking enough fluid, which lets minerals in the urine become concentrated enough to crystallize. Diet, body weight, family history, certain medical conditions, and some medications also play a part. The type of stone points to the underlying cause, which is why analyzing a stone you pass — and testing your urine — is so useful.

What are the types of kidney stones?

There are four main types. Calcium stones (usually calcium oxalate) are by far the most common, making up about 80%. Uric acid stones form in urine that's too acidic, often linked to diet, gout, or excess weight. Struvite stones are tied to certain urinary infections and can grow large. Cystine stones are rare and caused by an inherited condition. Knowing the type shapes how the stone is prevented.

Can drinking water dissolve a kidney stone?

Water won't dissolve an existing stone, but staying very well hydrated is still the most important thing you can do — it helps small stones pass and is the foundation of preventing new ones. The one exception is that uric acid stones can sometimes be partly dissolved by making the urine less acidic with medication, which a doctor would direct. For other stone types, treatment to remove a stuck stone is a urologist's job.

How long does it take to pass a kidney stone?

It varies a lot by size and location. Many small stones (under about 4–5 mm) pass on their own within days to a few weeks, often with fluids and pain control. Larger stones are less likely to pass and may need a urologist to remove or break them up. If pain is severe and unrelenting, you can't keep fluids down, or you develop a fever, don't wait it out — get care.

Are kidney stones linked to kidney disease?

They can be. Most people who form an occasional stone keep normal kidney function, but recurrent stones, repeated blockages, or repeated infections can stress the kidneys over time and raise the risk of chronic kidney disease. That's one reason a nephrologist's role in prevention matters — protecting long-term kidney function, not just managing the pain of a single stone.

Why would I see a nephrologist instead of a urologist for stones?

See a urologist to remove or break up a stone that won't pass. See a nephrologist to understand why stones keep forming and to build a prevention plan — especially if you've had more than one stone, have a single (solitary) kidney, have kidney disease, or want to stop the cycle of recurrence. For people who form stones repeatedly, both specialists working together gives the best result.

Kidney Stones: Symptoms, Types, Prevention & When It's an Emergency

Q: When is a kidney stone an emergency?

Seek emergency care right away if you have a fever or chills along with stone pain — that can signal an infection trapped behind a blocked stone, which is a true medical emergency. Also seek prompt care for pain you can't control, persistent vomiting, blood in the urine that's heavy, or trouble passing any urine at all. Most stones are miserable but not dangerous; these signs are the exceptions that need urgent attention.

Q: How can I prevent kidney stones from coming back?

Staying well hydrated is the single most helpful step for most people — enough fluid that your urine stays pale, generally aiming for at least about 2 liters of urine a day. Beyond that, prevention is tailored to your stone type and your urine chemistry, and may involve specific diet changes (around salt, animal protein, oxalate, or citrate) and sometimes medication. A nephrologist's metabolic evaluation is what makes the plan precise rather than guesswork.

The short answer

Kidney stones are hard mineral deposits that form in the kidneys and can cause sharp, wave-like pain in the back or side, blood in the urine, and nausea. A nephrologist's role is to find out why stones are forming and prevent new ones — often with blood tests and a 24-hour urine collection — while a urologist removes or breaks up stones that won't pass. The two work together. Once you've had one stone, you're more likely to form another, which is why finding the cause matters.

Quick reference

What they are: hard deposits of minerals and salts that form inside the kidneys.
How common: about 1 in 10 people will have a kidney stone in their lifetime.
Hallmark symptom: sharp pain in the back or side, often in waves, often with blood in the urine.
True emergency: fever or chills with a stone — it can mean a dangerous, blocked infection.
Two specialists: nephrologist finds the cause and prevents recurrence; urologist removes the stone.
Biggest prevention step: drink enough fluid to keep your urine pale — aim for about 2+ liters of urine a day.

What are kidney stones?

Kidney stones are hard deposits made of minerals and salts that form inside the kidneys. They start when the urine becomes concentrated — usually because there isn’t enough fluid — and substances that are normally dissolved, like calcium, oxalate, and uric acid, crystallize and stick together. A stone can be as small as a grain of sand or, occasionally, as large as a golf ball.

Small stones often pass on their own through the urinary tract. The trouble comes when a stone is large enough to lodge — most often where the narrow tube from the kidney (the ureter) carries urine toward the bladder. A blocked stone backs up pressure and triggers the sharp, unmistakable pain that brings most people in.

1 in 10

people will have a kidney stone at some point in life — and once you’ve had one, you’re more likely to form another, which is exactly why finding the cause matters.

Here’s the part that’s easy to miss in the middle of the pain: a stone isn’t just a one-time event to get through. For many people it’s a signal — a clue about diet, hydration, or body chemistry that, once understood, can be changed. That’s the difference between treating this stone and preventing the next one.

What are the symptoms of a kidney stone?

A stone sitting quietly in the kidney may cause nothing at all. Symptoms usually begin when it starts to move and block the flow of urine:

Sharp pain in the back or side, below the ribs, often coming in waves that build and ease — this is the classic symptom, and it can be intense
Pain that radiates to the lower belly and groin as the stone moves
Blood in the urine — pink, red, or brown
Pain or burning when you urinate
A frequent, urgent need to urinate, often passing only small amounts
Nausea and vomiting
Urine that looks cloudy or smells unusual

The pain of a kidney stone is often described as among the sharpest there is — frequently compared to childbirth. It tends to come in waves rather than stay steady, because it tracks the stone’s movement.

These symptoms overlap with other conditions, including urinary infections and, in some cases, problems that need urgent attention. If you’re not sure what’s causing severe flank pain, it’s reasonable to be evaluated rather than guess.

When is a kidney stone an emergency?

Most kidney stones are miserable but not dangerous. A few situations, though, need urgent or emergency care — don’t wait these out:

Fever or chills along with stone pain. This is the big one. It can mean an infection is trapped behind a blocked stone — a true emergency that can become serious quickly and needs care the same day.
Pain you can’t control, even with the medication you have on hand.
Persistent vomiting that keeps you from holding down fluids.
Trouble passing any urine at all, which can signal a blockage that needs prompt relief — especially urgent if you have only one working kidney.
Heavy blood in the urine, or pain so severe it’s hard to stay still.

When in doubt, the combination of a known or suspected stone plus a fever should always send you for emergency care. The rest of the time, a stone can usually be managed without an emergency-room visit — but it’s worth being seen so the cause can be sorted out.

The types of kidney stones — and what causes them

Stones aren’t all the same, and the type matters because it points to the cause and shapes how the stone is prevented. Most stones come from a mix of too little fluid, diet, body chemistry, and sometimes an inherited tendency.

The four main stone types
Type	How common	What drives it
Calcium (usually calcium oxalate)	Most common — about 80%	Concentrated urine, high oxalate or sodium intake, low citrate, low fluid
Uric acid	A notable share	Urine that’s too acidic; linked to diet high in animal protein, gout, and excess weight
Struvite	Less common	Certain urinary tract infections; can grow large quickly
Cystine	Rare	An inherited condition (cystinuria) that leaks cystine into the urine

You’re at higher risk of stones if you don’t drink enough fluid, eat a diet high in salt or animal protein, are overweight, have had stones before or have a family history, or have certain conditions — including chronic kidney disease, gout, recurrent urinary infections, or some digestive diseases. Certain medications and supplements can contribute too.

Whenever possible, a stone you pass should be saved and sent for analysis. Knowing its exact composition is one of the most useful clues for preventing the next one — it tells your team which levers actually matter for you.

How are kidney stones diagnosed?

When a stone is suspected, the goal is to confirm it, find where it is, and understand why it formed. Diagnosis usually involves:

Imaging — most often a CT scan, which finds stones accurately and shows their size and location; ultrasound is also used, especially to limit radiation
A urine test (urinalysis) to look for blood in the urine, signs of infection, and crystals
Blood tests to check kidney function, calcium, uric acid, and related levels
Stone analysis, if you’re able to catch and save a stone you pass

Imaging and the immediate workup are often done in an urgent or urology setting when you’re in acute pain. The why-did-this-happen part — the metabolic evaluation — is where a nephrologist comes in, usually once the acute episode has settled.

Should you see a nephrologist or a urologist?

This is the question that confuses people most, and the answer is simpler than it sounds: it depends on whether the job is removing a stone or preventing the next one.

Urologist — removes the stone

A surgeon for the urinary tract. Treats stones that won’t pass — breaking them up or removing them with procedures such as shock-wave lithotripsy, ureteroscopy, or percutaneous removal. The right call for acute blockage and surgery.

Nephrologist — prevents the next one

A kidney specialist focused on why stones form. Runs the metabolic evaluation, identifies the underlying cause, protects long-term kidney function, and builds a prevention plan — especially for recurrent stones.

In practice the two roles work together. For a single stone that passes easily, a urologist or your primary care doctor may be all you need. But if you’ve had more than one stone, have a single kidney, have kidney disease, or simply want to break the cycle of recurrence, a nephrologist’s metabolic workup is the piece that addresses the root cause.

Our role at Georgia Nephrology is the prevention side — finding out why the stones keep forming and how to stop them — while urology treats the stone itself. We coordinate so your care stays connected.

Georgia Nephrology does not perform stone-removal procedures or surgery. When a stone needs treatment, we coordinate with urology — and we focus on what we do best: the metabolic evaluation and a prevention plan tailored to you. For an overview of how we approach this, see our general nephrology services.

Had more than one stone? A metabolic evaluation can tell you why — and how to stop the cycle.

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The 24-hour urine test and metabolic workup

If there’s one tool that sets thorough stone prevention apart, it’s the 24-hour urine collection. You collect all of your urine over a full day, and the lab measures the things that promote stones (like calcium, oxalate, sodium, and uric acid) and the things that protect against them (like citrate and overall urine volume). Together with blood work and your stone’s composition, it paints a picture of your specific chemistry.

That picture is what turns prevention from generic advice into a precise plan. It’s recommended particularly for people who:

Have had more than one stone, or form them repeatedly
Have a single (solitary) kidney or existing kidney disease
Are at high risk of recurrence, or simply want to do everything possible to prevent the next stone

Because the test guides which diet changes and which (if any) medications will actually help you, it’s a core part of what a nephrologist offers. Several of our offices have on-site labs, which makes the testing and follow-up easier to fit into your life. The collection is sometimes repeated later to confirm that the plan is working.

How to lower your risk of future stones

For most people, the single most powerful step is staying well hydrated — enough that your urine stays pale, generally enough fluid to produce at least about 2 liters of urine a day. After that, prevention is tailored to your stone type and your urine chemistry:

Drink enough to keep urine pale. Water is the foundation; spread it through the day, and drink more in Georgia’s heat or with heavy activity.
Go easy on salt. High sodium pushes more calcium into the urine, which feeds the most common stones.
Don’t overdo animal protein. Large amounts of meat, poultry, and seafood can raise stone risk, including uric acid stones.
Keep normal dietary calcium. For most calcium-stone formers, cutting calcium backfires — getting it from food (not high-dose supplements) actually helps.
Mind oxalate if your stones call for it, and consider citrate-rich foods like citrus — but let your stone type guide the specifics.
Take prescribed medication when indicated. For some people, drugs like a thiazide, potassium citrate, or allopurinol meaningfully cut recurrence.

A nephrologist’s metabolic evaluation is what makes this plan precise rather than guesswork — matching each change to what your own urine and stone analysis reveal.

Myths and facts about kidney stones

If I cut out all calcium, I’ll stop forming calcium stones.

For most people it’s the opposite — normal dietary calcium helps. It’s high salt, low fluid, and other factors that drive calcium stones, not calcium from food.

Drinking lots of water will dissolve the stone I have.

Water won’t dissolve most existing stones, but staying very hydrated helps small ones pass and is the best way to prevent new ones.

A stone is a one-time event — once it passes, I’m done.

Once you’ve had a stone, you’re more likely to form another. Finding the cause is how you change those odds.

Beer or special drinks flush stones out.

No drink is a treatment. Plain water and a plan based on your stone type are what actually work.

When should you see a nephrologist?

It’s worth seeing a kidney specialist about stones when:

You’ve had more than one stone, or you form them repeatedly
You have a single (solitary) kidney, which makes any blockage higher-stakes
You have kidney disease or reduced kidney function
A stone you passed turned out to be uric acid, struvite, or cystine — types that especially benefit from targeted prevention
You want a metabolic evaluation to understand the cause and stop the cycle
Your family history of stones is strong

Seeing a nephrologist doesn’t replace urology — it complements it. The urologist handles the stone in front of you; the nephrologist helps make sure there isn’t a next one. If you’ve had a stone and want to know why, find a location near you and let’s get to the bottom of it.

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Kidney Stones