Imagine living with the challenges of lupus, only to face another unexpected hurdle: kidney stones. Lupus can cause various health problems beyond its well-known symptoms. Although lupus can affect kidney function, it isn’t directly related to kidney stones. It’s estimated that as many as 5 out of 10 adults with lupus develop kidney disease, as do 80 percent of children with lupus. This condition is called lupus nephritis, but kidney stones aren’t a symptom.

Nonetheless, several MyLupusTeam members report having had kidney stones. And kidney stone complications, like urinary tract infections, may be harder to manage when you have lupus. Doctors may have a harder time detecting infections in people with autoimmune diseases, and immunosuppressive drugs can reduce your body’s ability to fight off infections.

Knowing why kidney stones form can help you prevent the stress and complications they bring.

Who Gets Kidney Stones?

Kidney stones are relatively common, affecting about 9 percent of women and 11 percent of men in the U.S., according to the National Kidney Foundation. There are four general types of kidney stones:

• Calcium oxalate stones
• Uric acid stones
• Struvite stones
• Cystine stones

Kidney stones come in a wide range of dimensions, from a tiny grain of sand to the size of a golf ball. Larger stones cause greater symptoms. If you have a kidney stone, you may notice pain on either side of your lower back.

Other symptoms include a persistent stomachache and vomiting. You may mistake the fever and chills of a kidney stone as a baseline lupus symptom. Both kidney stones and lupus nephritis cause urine changes, like blood in the urine or foamy urine.

What Causes Kidney Stones?

The most common type of kidney stone is calcium oxalate, which happens when calcium and oxalate bind together in the urine. About 80 percent of kidney stones are calcium oxalate stones. Not consuming enough water or calcium contributes to calcium oxalate stones, but these aren’t the only potential causes.

Uric acid stones are another common type, making up 5 percent to 10 percent of kidney stones, as cited by the Urology Care Foundation. People prone to uric acid stones may need to avoid certain foods, including shellfish and organ meats (for example, liver, kidneys, heart, brain, or tongue). These foods are high in purines, a compound associated with uric acid stones. Additional risk factors for uric acid stones include being of a higher weight, having high blood sugar or diabetes, chronic diarrhea, and gout.

Infections in the upper urinary tract can lead to a rare type of kidney stone called struvite stones. Another uncommon form of kidney stones, cystine stones, is genetic.

In general, people who can’t fully empty their bladder are more prone to urinary tract infections and, as a result, certain types of kidney stones.

How Are Kidney Stones Diagnosed?

To determine if you have a kidney stone, your doctor can do a CT scan. Once they know the size and location of your kidney stone, your health care provider can recommend treatment. Minimally invasive procedures, like shockwave lithotripsy or ureteroscopy, can help break up or remove the stone.

If your doctor doesn’t find a kidney stone with imaging tests, they’ll do more testing to check your kidney function and screen for lupus nephritis. Along with blood tests and urine tests, a kidney biopsy can help diagnose lupus nephritis.

Lupus Comorbidities and Kidney Stones

Lupus doesn’t cause kidney stones. But kidney stones and lupus share some overlapping factors. For instance, obesity, high blood pressure, and diabetes increase the risk of kidney stones. And these conditions tend to be higher in people with lupus compared to the general population.

Lupus Medications and Kidney Stones

Most lupus medications haven’t been studied in relation to kidney stones. Certain medications, such as diuretics used for lupus nephritis and certain antibiotics, can raise the risk of developing kidney stones. A diuretic is a type of medication that helps the body get rid of excess water and salt by making you produce more urine. Medications used to treat seizures or migraines, including topiramate (sold under the brand names Topamax, Trokendi XR, and Qudexy XR), increase the risk of calcium-based kidney stones. Certain dietary supplements, such as calcium and vitamin C, can also raise the risk of kidney stones.

Ultimately, all medications and supplements have some side effects, but doctors choose to recommend them when the pros outweigh the cons. If you have a personal or family history of kidney stones, ask your doctor whether your lupus treatments may increase your risk. Never discontinue or change medications before receiving medical advice from your health care provider.

Discussions About Kidney Stones on MyLupusTeam

Although lupus doesn’t cause kidney stones, some people with lupus may still experience them at some point in their lives. Members of MyLupusTeam have talked about their struggles with kidney stones and the pain they cause.

One MyLupusTeam member shared their experience after coming home from the emergency room. “I’ve been having horrible kidney pain in both kidneys. I also have a kidney stone,” they explained. “They said I have urine left in my kidneys, so I have a kidney infection. Has anyone else gone through this pain?”

Another responded, “I also just wound up in the ER with a kidney stone and a swollen kidney due to the backlog of urine. It was the worst pain I’ve ever had.”

How Lupus Nephritis Differs From Kidney Stones

In lupus nephritis, the body’s immune system attacks the kidneys. This inappropriate immune response causes kidney inflammation and kidney damage. Some of the signs are similar to kidney stones, but additional symptoms of lupus nephritis include:

• High blood pressure
• Proteinuria (protein in the urine)
• Edema (swelling)
• Impaired kidney function

Some people with lupus nephritis progress to kidney failure and require dialysis treatments or a kidney transplant.

How To Lower Your Risk of Kidney Stones With Lupus

Drinking plenty of fluids, reducing your meat intake, cutting back on sodium, and eating plenty of fruits and vegetables can help lower your risk of kidney stones. Aim to stay hydrated with plenty of water (rather than sugary drinks). Your urine should be a pale yellow color. Dark urine is a sign that you may not be drinking enough.

Filling your diet with lots of fresh fruits and vegetables helps support healthy kidneys. These heart-healthy foods are good for reducing high blood pressure, which is an added strain on the kidneys. Fresh fruits and veggies are naturally low in sodium and high in beneficial fiber, which is good for blood sugar control and weight management. By focusing on fruits and vegetables in your diet, you’ll fill up on nutritious foods and rely less on meat and animal products.

Animal products, like meat and eggs, can make your urine more acidic. If your urine is acidic, you are more likely to get certain types of kidney stones. While you don’t need to avoid meat completely, balancing these foods with plenty of water and vegetarian options can help maintain a healthier balance to reduce your risk of stones.

To get less salt in your diet, aim to cook from home as much as possible. Restaurant meals and fast food are particularly high in salt. Learn to read food labels so you can select products with reduced sodium or no added salt.

Meeting with a registered dietitian nutritionist who specializes in renal medicine can help you figure out the right amount of fluid to drink and how to structure your diet. If you have a history of a specific type of kidney stone or if you have lupus nephritis, diet can play a significant role in your quality of life and long-term health.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 people with lupus come together to ask questions, give advice, and share their stories.

Do you have a history of kidney stones? Have you met with a nephrologist for kidney problems related to lupus? Post your thoughts in the comments below, or start a conversation by sharing on your Activities page.