Kidney Stone Symptoms and Characteristics

Primary Symptoms

The American College of Radiology recommends considering renal colic as a primary symptom of kidney stones, characterized by severe, sudden-onset pain typically located in the flank that may radiate to the lower abdomen and groin, caused by ureteral hyperperistalsis as the stone moves through the urinary tract 1, 2
Hematuria, or blood in the urine, is a common symptom resulting from irritation and trauma to the ureter by the stone, as reported by the American College of Radiology 1

The Journal of Urology states that kidney stones may cause dull, aching flank pain or be asymptomatic if not causing obstruction 3
European Urology reports that upper ureteral stones can cause severe flank pain that may radiate to the upper abdomen, while mid-ureteral stones cause pain that may radiate anteriorly and toward the groin 4
Distal ureteral stones can cause pain that commonly radiates to the groin, testicle in men, or labia in women, according to The Journal of Urology 5

The American College of Radiology notes that hydronephrosis, or swelling of the kidney due to ureteral obstruction, can worsen pain and potentially lead to kidney damage 1, 6
The Journal of Urology states that urinary tract infection can present with fever, chills, cloudy or foul-smelling urine, and is a common complication of kidney stones 3, 7
Sepsis, a life-threatening complication of obstructed infected stones, can present with high fever, hypotension, and altered mental status, as reported by The Journal of Urology 5

European Urology reports that stone size is a significant factor in symptom severity, with stones <5 mm typically causing milder symptoms and having a 75% chance of spontaneous passage, while stones ≥5 mm cause more severe symptoms and have a 62% passage rate 8, 4
The passage rates of stones vary by location, with 49-52% for upper ureteral stones, 58-70% for mid-ureteral stones, and 68-83% for distal ureteral stones, according to European Urology 8

European Urology notes that asymptomatic stones, particularly those that remain in the kidney and don't cause obstruction, may be completely asymptomatic and discovered incidentally on imaging 4
The Journal of Urology states that renal colic is the most common non-obstetric cause of abdominal pain requiring hospitalization during pregnancy 5

The Journal of Urology and European Urology recommend that fever with flank pain suggests possible infection with obstruction, a urological emergency 3, 8
European Urology notes that anuria, or complete cessation of urine output, suggests bilateral obstruction or obstruction of a solitary kidney, requiring immediate medical attention 4
The Journal of Urology reports that signs of sepsis, including high fever, hypotension, tachycardia, or altered mental status, are a medical emergency 5