Kidney Stones in Older Adults: What Seniors and Care Managers Need to Know

Kidney stones may not be the most dangerous kidney condition, but they can be incredibly painful and can seriously affect quality of life—especially for older adults. As we age, the risk of developing kidney stones increases, making awareness and prevention key components of senior healthcare.

Whether you’re a geriatric care manager, caregiver, or concerned family member, understanding how to recognize, treat, and prevent kidney stones in seniors can lead to better outcomes and reduced complications.

What Are Kidney Stones?

Kidney stones are hard, pebble-like deposits that form when certain minerals in the urine crystallize in the kidneys. Many people may have kidney stones without realizing it—some stones are small and pass naturally with little or no symptoms. But when a stone becomes too large or jagged, it can block the flow of urine and cause intense pain and medical complications.

There are several types of kidney stones, each caused by different factors:

• Calcium oxalate stones – the most common type, often caused by high calcium or oxalate levels in urine
• Uric acid stones – linked to high purine levels (from foods like red meat and shellfish)
• Struvite stones – caused by chronic urinary tract infections (UTIs)
• Cystine stones – rare, genetic, and caused by excess cystine in the urine

Who Is at Risk of Kidney Stones?

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 11% of men and 6% of women will experience kidney stones in their lifetime. Older adults are at increased risk due to a combination of age-related changes and chronic health conditions.

Risk factors for kidney stones in seniors include:

• Family or personal history of kidney stones
• Chronic kidney disease or urinary tract infections
• Incontinence or holding urine for long periods
• High blood pressure, diabetes, and obesity
• Low fluid intake or dehydration, often due to reduced thirst
• High-sodium, high-sugar diets
• Certain medications that affect calcium or uric acid levels

For older adults, especially those who are sedentary or have limited access to hydration, these risks can add up quickly.

Symptoms of Kidney Stones in Seniors

While kidney stones can occur without warning, some symptoms to watch for include:

• Severe back or abdominal pain that doesn’t go away
• Blood in the urine (hematuria)
• Frequent or painful urination
• Cloudy, foul-smelling urine
• Nausea or vomiting
• Fever and chills (possible sign of infection)

Older adults may not always express pain clearly, especially those with cognitive decline or dementia, so caregivers and care managers should be alert to changes in behavior or appetite, which can indicate discomfort or infection.

How Kidney Stones Are Diagnosed

Diagnosis typically involves a combination of physical exams, blood and urine tests, and imaging tools like X-rays or CT scans. These tests help identify the size, type, and location of the stone, and whether there’s a blockage or infection requiring urgent care.

Prompt diagnosis is essential to prevent complications such as urinary tract infections, kidney damage, or sepsis in vulnerable older adults.

Treatment Options for Kidney Stones

Small stones often pass naturally with increased fluid intake and pain management. However, larger or irregularly shaped stones may require medical intervention. Common treatment options include:

• Shock wave therapy (lithotripsy) to break the stone into smaller pieces
• Ureteroscopy, using a scope to locate and remove the stone
• Surgical removal, in severe or complex cases

Delayed treatment can lead to infections, kidney function loss, or hospitalization, so it’s crucial to act quickly if a senior shows signs of a stone.

How to Prevent Kidney Stones in Older Adults

Prevention starts with identifying the type of kidney stone, which can guide dietary, lifestyle, and medical changes. Key prevention strategies include:

1. Stay Hydrated

• Encourage regular fluid intake to keep urine diluted
• Work with the care team to set safe hydration goals, especially for seniors with heart or kidney conditions

2. Modify Diet

• Limit high-sodium, high-oxalate, and high-purine foods
• Increase intake of fruits, vegetables, and foods that support kidney health
• Consult a renal dietitian for personalized nutrition advice

3. Monitor Medications

• Some prescriptions may increase stone risk—review regularly with a healthcare provider

4. Manage Chronic Conditions

• Control blood pressure, blood sugar, and weight to reduce overall kidney strain

5. Use Prescribed Preventive Medications

• In some cases, doctors may prescribe stone-prevention medications based on the stone type

Why Kidney Stone Awareness Matters in Geriatric Care

For older adults, kidney stones can be more than just painful—they can be dangerous if left untreated or mismanaged. As a geriatric care manager, you are in a unique position to:

• Recognize early warning signs
• Coordinate timely diagnosis and treatment
• Promote hydration and nutrition
• Educate family caregivers on prevention
• Advocate for follow-up and ongoing monitoring

If you’re concerned about a senior’s risk of kidney stones—or need help developing a kidney health plan—our LiveWell team is here to support you with expert guidance, personalized care strategies, and compassionate advocacy.

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