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Kidney Disease & Kidney Stones

About 1 in 7 U.S. adults has chronic kidney disease — and most don’t know it, because early kidney disease has no symptoms. Kidney stones are common too. This guide explains the tests, the stages, what slows kidney damage, how stones are treated and prevented, and which “natural” remedies can harm your kidneys.

Get urgent care right away — or go to an emergency room — for severe pain in your back or side (often on one side, sometimes spreading to the groin), especially with fever, chills, nausea or vomiting, or if you can’t pass urine or can pass only a little. These can be signs of a kidney stone blocking the flow of urine, or of a kidney infection (NIDDK, MedlinePlus, NHS). A kidney infection can lead to sepsis, which can be life-threatening (NIDDK, CDC).

Call 911 if you are confused, very drowsy or have trouble speaking (NHS), or if you are passing little or no urine along with swelling of the feet or legs, shortness of breath or confusion. These can be signs of sudden kidney injury or sepsis (NHS, NIDDK).

See a doctor soon about blood in your urine — pink, red or brown urine — even if there is only a little, or you aren’t sure it’s blood (NHS, NIDDK).

Your kidneys filter your blood, remove wastes and extra water as urine, keep the body’s chemicals balanced, help control blood pressure and make hormones (MedlinePlus). This guide covers chronic kidney disease and kidney stones, with short notes on kidney infection, sudden (acute) kidney injury and polycystic kidney disease. For kidney failure, dialysis or a transplant, see our Dialysis & Kidney Failure guide.

Chronic kidney disease (CKD)

In CKD, the kidneys are damaged and can’t filter blood as they should, so wastes and extra fluid build up. It usually develops slowly. Advanced, long-lasting CKD typically can’t be reversed and can lead to kidney failure — but the sooner you know, the sooner you can protect your kidneys (NIDDK). Not everyone with CKD reaches kidney failure, and treatment has been shown to slow it (CDC).

How common is it?

CDC’s estimates, updated in March 2026, found that 14 percent of U.S. adults — about 37 million people — have CKD, and 87 percent of adults with CKD didn’t know it. CKD was found in 38 percent of adults with diabetes and 21 percent of adults with high blood pressure. It was most common at age 65 and older (34 percent) and more common in non-Hispanic Black adults (22 percent) than in non-Hispanic White adults (13 percent). CDC notes the estimates come from a single round of tests and may overstate the numbers (CDC).

Causes and symptoms

The most common causes are diabetes, which damages the kidneys’ filters, and high blood pressure, which damages their blood vessels. Others include lupus and other immune diseases, glomerular diseases, polycystic kidney disease, medicines that are toxic to the kidneys, and acute kidney injury (NIDDK). Heart failure, a family history of CKD, and overweight or obesity also raise the risk (CDC). See our Diabetes and Blood Pressure guides.

Early CKD usually has no symptoms. Later, people may notice swelling in the legs, feet or ankles, poor appetite or nausea, tiredness, trouble concentrating, foamy urine, itching, muscle cramps, or shortness of breath (NIDDK).

The two tests — and your stage

Testing is the only way to know how well your kidneys work, and the same two tests track CKD over time (NIDDK):

  • eGFR (estimated glomerular filtration rate), a blood test that uses your creatinine level to estimate how well your kidneys filter (MedlinePlus). An eGFR under 60 may mean kidney disease; under 15 may mean the kidneys are failing (CDC).
  • UACR (urine albumin-to-creatinine ratio), a urine test for albumin, a protein that leaks into urine when kidneys are damaged. A result of 30 mg/g or less is normal; above 30 may be a sign of kidney disease, and the test may be repeated to confirm it (NIDDK).

By eGFR, stage 1 is a normal eGFR (above 90) with other signs of kidney damage; stage 2 is 60–89 with signs of damage; 3a is 45–59; 3b is 30–44; 4 is 15–29; and 5 is below 15, when the kidneys have lost almost all their function. Urine albumin is graded A1 to A3; for both, a higher stage means more severe disease (NHS). Ask your clinician what your own numbers mean (MedlinePlus). People with diabetes should be tested every year; people with high blood pressure, heart disease or a family history of kidney failure should ask how often (NIDDK).

CKD also raises the risk of heart disease and stroke (CDC) — see our Heart guide — and of anemia, bone problems, high potassium and sudden kidney injury (NIDDK).

Kidney stones

Kidney stones are hard, pebble-like pieces that form when urine has high levels of certain minerals. A small stone may pass on its own; a larger one can get stuck, block urine and cause severe pain or bleeding. About 11 percent of men and 6 percent of women in the U.S. have a stone at least once. The four main types are calcium stones (the most common), uric acid stones, struvite stones that may follow a urinary infection, and cystine stones from an inherited disorder. Not drinking enough, a past stone, a family history, obesity and gout all raise the risk (NIDDK).

Stone pain usually starts in the side or lower back, may spread to the groin, and can come and go in waves. Other signs include blood in the urine, pain or urgency when urinating, cloudy urine, nausea, vomiting, fever and chills (NIDDK, NHS). Urine and blood tests and a scan confirm a stone (MedlinePlus).

Other kidney problems, in brief

Kidney infection (pyelonephritis) is a urinary tract infection that usually starts in the bladder and spreads up to the kidneys. It causes fever and chills, back, side or groin pain, painful urination and sometimes vomiting; seek care right away (NIDDK). It is treated with antibiotics, sometimes through an IV in the hospital (NIDDK). It is more likely in women, during pregnancy, and with a blockage such as a stone (NIDDK). See our Cystitis guide.

Acute kidney injury (AKI) is a sudden drop in kidney function. Causes include infection, dehydration, blockages such as stones, some medicines including NSAIDs, and contrast dye used in some scans. Many people recover fully within weeks, but some are left with chronic kidney disease (NHS).

Polycystic kidney disease (PKD) is an inherited disorder in which many fluid-filled cysts grow in the kidneys. It is a form of CKD that may lead to kidney failure, and it affects about 500,000 people in the U.S. (NIDDK). A child has a 1 in 2 chance of inheriting the main adult form if one parent has it (NHS).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) CKD: blood pressure and blood sugar control, ACE inhibitors or ARBs, SGLT2 inhibitors, finerenone for some people with type 2 diabetes, avoiding NSAIDs, medicine reviews and a dietitian. Stones: pain relief, sometimes an alpha blocker, lithotripsy or ureteroscopy, then prevention by stone type. Medicare covers dietitian visits (medical nutrition therapy) at no cost for kidney disease with a referral, and up to 6 kidney disease education sessions at stage 4. Stone procedures: cost estimate being researched. Treatment can’t cure CKD but can slow it and lower heart risks. Most stones pass on their own; larger ones are broken up or removed.
Chiropractic No role. We found no evidence that chiropractic care treats kidney disease, kidney stones or kidney infection. Not recommended for kidney problems, so no cost estimate is given. Back or side pain from a stone or infection needs medical care first.
Acupuncture Studied as an add-on for the sudden pain of a kidney stone (renal colic). We found little research on acupuncture for chronic kidney disease. About $90–$185 per follow-up visit and $125–$230 for a first private visit (cash prices). Medicare covers acupuncture only for chronic low back pain. Small, mostly lower-quality trials suggest faster relief of renal colic. It doesn’t remove stones or treat CKD.
Herbal medicine Not a treatment. Many herbs and supplements are dangerous with CKD (aristolochic acid, high-potassium products, star fruit). Chanca piedra for stones has limited evidence; cranberry doesn’t treat kidney disease. Not applicable — check every product with your care team first. Possible harm, including kidney damage, dangerous potassium levels and interactions with your medicines.
Massage therapy No role in treating kidney disease or stones. Gentle massage for comfort only, never on a dialysis access arm. Not a kidney treatment, so no cost estimate is given. Comfort at most. New swelling needs a medical check, not massage.
MBHA Wellness Coach Fluids to prevent stones, less salt, home blood pressure checks, diabetes care, safer pain relief, screening if you’re at risk, protein with a dietitian, quitting smoking. MBHA coaching: being researched. Supports — never replaces — your medical team. Daily habits help slow CKD and prevent stones.

Approach 1 of 6

Conventional medicine (AMA)

A primary care clinician usually leads, with a nephrologist (kidney specialist) if CKD is complicated, advanced or worsening quickly; a dietitian and pharmacist are key team members (NIDDK). A urologist treats stones (NIDDK). We name medicines but never doses.

Slowing chronic kidney disease

  • Blood pressure control is the most important step, and meeting your blood sugar goals matters if you have diabetes (NIDDK). Aim for the target your clinician sets (CDC).
  • ACE inhibitors and ARBs (names ending in –pril or –sartan) may slow kidney disease and delay kidney failure, even without high blood pressure (NIDDK).
  • SGLT2 inhibitors. Dapagliflozin’s FDA-approved label includes lowering the risk of kidney function decline, kidney failure, cardiovascular death and heart failure hospitalization in adults with CKD at risk of getting worse; it is not recommended for CKD caused by polycystic kidney disease (FDA label). Empagliflozin is also used to reduce the risk of worsening kidney disease in certain adults (MedlinePlus, MedlinePlus). They don’t suit everyone (NHS).
  • Finerenone was FDA-approved in 2021 to lower kidney and heart risks in adults with CKD linked to type 2 diabetes; side effects include high potassium and low blood pressure (FDA).
  • Statins or other cholesterol medicines help protect the heart (NHS).
  • Avoid NSAIDs such as ibuprofen and naproxen unless a clinician advises them; they can damage the kidneys and cause acute kidney injury (NIDDK, NHS).
  • Medicine reviews. As kidney function falls, medicines can build up, so your clinician may lower a dose, give it less often or switch it. Tell your team about every medicine, vitamin and supplement (NIDDK). Contrast dye used in some scans can also injure the kidneys (NHS), so mention your CKD before a scan.
  • A renal dietitian: needs for sodium, potassium, phosphorus, protein and fluids change as CKD advances, and there is no single plan for everyone (NIDDK).
  • A yearly flu shot, because people with CKD have a higher risk of severe flu (CDC).

If kidney function keeps falling, learn about your options early in our Dialysis & Kidney Failure guide.

Treating kidney stones

  • Small stones: fluids, pain medicine and anti-sickness medicine; you may be asked to catch the stone so a lab can test it (NIDDK, NHS).
  • Alpha blockers, such as tamsulosin, are sometimes used for kidney stones (MedlinePlus). A 2018 Cochrane review of 67 studies found they likely help more stones clear but probably slightly raise the risk of major side effects, and may help less for stones 5 mm or smaller (Cochrane review, 2018).
  • Procedures for larger or blocking stones: shock wave lithotripsy breaks the stone from outside the body; ureteroscopy passes a thin scope through the urethra to remove or break it, usually with a same-day discharge; and percutaneous nephrolithotomy works through a small cut in the back (NIDDK). A stone that blocks urine and causes infection may need a procedure as well as antibiotics (NIDDK).

Preventing the next stone

Prevention depends on your stone type, so ask what yours was; a 24-hour urine test may help (NIDDK).

  • Fluids, mainly water, matter most for most types; citrus drinks may also help because their citrate stops crystals becoming stones (NIDDK).
  • Calcium stones: cut sodium, limit animal protein and get enough calcium from food; for calcium oxalate stones, you may be told to limit high-oxalate foods such as spinach, rhubarb, nuts and wheat bran (NIDDK).
  • Uric acid stones: limit animal protein and lose weight if needed (NIDDK).
  • Medicines by type: potassium citrate, diuretics, allopurinol (uric acid stones) or antibiotics (struvite stones) (NIDDK).

Polycystic kidney disease

Treatment targets blood pressure (often ACE inhibitors or ARBs), pain, stones and infections, and NSAIDs are usually avoided. Tolvaptan can slow cyst growth in some adults whose disease is worsening quickly; liver damage has been reported, so people taking it are monitored closely (NHS).

What it costs

  • Dietitian: Medicare Part B covers medical nutrition therapy for kidney disease (or a transplant in the last 36 months) with a doctor’s referral; you pay nothing if you qualify (Medicare.gov).
  • Kidney disease education: with stage 4 CKD and a referral, Part B covers up to 6 sessions; you pay 20 percent of the Medicare-approved amount after the deductible (Medicare.gov).
  • Tests, medicines and stone procedures: cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in treating kidney disease, stones or infection. We found no studies showing it changes kidney function or helps stones pass.

  • Kidney pain can feel like back pain. Stone pain often starts in the lower back or side (NHS), and a kidney infection can cause back or side pain with fever (NIDDK). Sudden, severe one-sided pain — especially with fever, vomiting, blood in the urine or trouble urinating — needs medical care first.
  • PKD: trauma to the back and sides may make kidney cysts burst (NIDDK); tell any practitioner who works on your back.
  • Safety: serious side effects of spinal manipulation are very rare but may be more likely in people whose health problems raise their risk of injury (NCCIH). Don’t accept supplements without your kidney team’s okay.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture doesn’t remove stones or treat CKD. Its kidney research is mostly about the sudden, severe pain of a stone (renal colic).

  • A 2022 review of 15 small trials (1,210 adults) found acupuncture seemed about as effective as pain medicines, with faster onset, but the evidence was generally low quality and the authors advised caution (systematic review, 2022). A second 2022 review of 13 trials found faster relief and fewer side effects than standard treatment, while noting the studies were few and limited (meta-analysis, 2022).
  • In a Chinese emergency-department trial, 80 people got a standard pain injection plus real or sham acupuncture. More in the acupuncture group had their pain halved within 10 minutes, but the need for extra pain medicine was the same (randomized trial, 2022). A second trial of 84 people also reported faster relief than sham (randomized trial, 2025). Both were small, single-center trials; acupuncture is an add-on, not a substitute for emergency assessment.
  • We found little research on acupuncture for CKD itself.

Safety: done improperly, acupuncture can cause infections, punctured organs and nerve injury; needles must be sterile and single-use (NCCIH). An arm with, or being saved for, a dialysis access needs protecting (NIDDK), so we suggest no needles there.

Cost: about $90 to $185 per follow-up and $125 to $230 for a first private visit, or $50 to $90 at community clinics (The Pricer). Medicare covers acupuncture only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Herbal medicine doesn’t treat kidney disease — and with CKD, many herbs and supplements are dangerous.

If you have kidney disease, check every herb, supplement and over-the-counter product with your pharmacist or clinician first (NIDDK, CDC).

Cranberry and chanca piedra

Cranberry is promoted for urinary tract infections, but there is little research for other conditions and it isn’t a treatment for an existing infection (NCCIH). Experts don’t think diet prevents or treats kidney infections (NIDDK), and cranberry is not a treatment for CKD or stones.

Chanca piedra (Phyllanthus niruri) is the most common ingredient in herbal stone products. A 2020 review found only two controlled studies, suggesting modest reductions in stone size and number, and called the evidence limited (meta-analysis, 2020). It is not a substitute for medical care. We don’t list doses.

Approach 5 of 6

Massage therapy

Massage has no role in treating kidney disease, stones or infection. Gentle massage may help some people relax, but stone or infection pain is not a muscle problem.

  • Swelling is a warning sign, not a massage target. Contact your clinician about swelling in your face, arms, legs or belly (NIDDK).
  • Protect any dialysis access. Your access is your “lifeline”, and an arm being saved for one needs protecting too (NIDDK); we suggest no massage or pressure on that arm.
  • PKD: trauma to the back and sides may make cysts burst (NIDDK), so we suggest gentle pressure only and no deep work there.
  • Serious harm from massage is rare, but blood clots, nerve injury and fractures have been reported, some after vigorous deep-tissue massage (NCCIH).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Most of what slows CKD and prevents stones happens day to day. An MBHA Wellness Coach can help you build habits — alongside, never instead of, your medical team.

  • Fluids, the right amount for you. For stones, drinking enough, mainly water, is the most important step; many clinicians suggest six to eight 8-ounce glasses a day (NIDDK), and dark urine means drink more (NHS). But people with CKD may need to limit fluids (NIDDK), so ask for your own target.
  • Less salt. Sodium raises blood pressure and fluid build-up and the chance of stones; most comes from packaged and restaurant food. Cook from scratch, read labels (5 percent Daily Value or less is low) and season with herbs and lemon (NIDDK, NIDDK).
  • Blood pressure at home. Ask your team about measuring it yourself (CDC) and bring a log to visits.
  • Diabetes. Meet your blood sugar targets as often as you can and have your A1C checked at least twice a year (CDC).
  • Screening. With diabetes, high blood pressure, heart disease, obesity or a family history of CKD, get tested regularly — yearly with diabetes (CDC).
  • Safer pain relief. Check labels for NSAIDs and ask your pharmacist what’s safe. Vomiting, diarrhea or not drinking enough lower blood flow to the kidneys, and NSAIDs taken while dehydrated can injure them, so ask ahead which medicines to pause when sick (NIDDK).
  • Protein with a dietitian. Some people with CKD need moderate protein, but too little causes malnutrition (NIDDK); limiting animal protein can help prevent some stones (NIDDK).
  • Quit smoking. Smoking can worsen kidney disease and interfere with blood pressure medicine (CDC); free coaching is at 1-800-QUIT-NOW (CDC).
  • Move, sleep, cope. Be active most days, aim for a healthy weight and 7 to 8 hours of sleep, and ask for help if you feel down — depression is common with long-term illness (NIDDK). Activity helps at every stage of CKD (CDC).

Another approach

Questions to ask at your next visit

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