Last updated: February 27, 2026
Medically reviewed by: NKF Patient Education Team
Contributions by: Melanie Betz MS, RD, CSR, FNKF, FAND, Founder & CEO, The Kidney Dietitian
Uric acid kidney stones are one of four main types of kidney stones. They form when urine is too acidic. They can be painful and may come back, but they are often preventable and sometimes can be dissolved with treatment.
Table of Contents
About uric acid kidney stones
Uric acid kidney stones are solid deposits of uric acid. Uric acid is a waste product formed when your body breaks down purines. Purines are natural substances found in certain foods and drinks, especially red and processed meat, seafood and alcohol. When your urine becomes too acidic and is too concentrated with uric acid, uric acid can crystallize and form kidney stones.
Only about 7% of kidney stones are made of uric acid. Calcium kidney stones are more common. Unlike other types of kidney stones, uric acid kidney stones can sometimes be dissolved with medication and diet changes by increasing the pH of your urine (making it less acidic).
Understanding your risk for uric acid kidney stones
These factors make it more likely that someone will have uric acid kidney stones:
- Diabetes, obesity, gout or metabolic syndrome
- Chronic kidney disease
- High uric acid levels in the blood
- A diet high in red or processed meat
- Frequent dehydration or ongoing fluid loss from diarrhea
- Family history of uric acid kidney stones
- History of weight loss surgery, especially gastric bypass
- Conditions that cause the body to produce too much acid
- Taking certain medications that affect uric acid levels
Symptoms of uric acid kidney stones
Similar to the other types of kidney stones, the symptoms of uric acid stones include:
- Severe back, side or groin pain
- Blood in your urine
- Frequent urination or a strong, sudden urge to urinate
- Pain or burning with urination
- Nausea or vomiting
Some stones are small and may pass on their own, but larger stones can block urine flow and cause more symptoms.
Fever and chills can be signs of infection and need urgent medical care.
Treatment for uric acid kidney stones
Treatment depends on the size of the stone, your symptoms, where the stone is located and your overall health.
Some uric acid kidney stones are small enough to pass on their own through your urine. Drinking fluids and managing pain may be all that is needed.
Unlike other types of kidney stones, uric acid stones can sometimes be dissolved by making your urine less acidic. This is done with medications such as potassium citrate or sodium bicarbonate. Diet and lifestyle changes may also help lower urine acid levels.
If a stone does not pass or dissolve, your doctor may recommend a procedure to remove it.
Common treatments include shock wave lithotripsy, which uses sound waves to break the stone into smaller pieces, and ureteroscopy, where a small camera is passed through the urinary tract to find and remove the stone.
Preventing Uric Acid Kidney Stones
The prevention of uric acid kidney stones depends on your urine chemistry (your 24-hour urine test) and other medical history. For most people, prevention of uric acid kidney stones includes:
- Hydration. Drink enough fluids to produce at least 2.5 liters of urine each day. For most people, this means drinking about 80 to 100 ounces of fluid daily. Your doctor may adjust this goal based on your health needs.
- Reduction of Urine Acid. Uric acid stones form in acidic urine, so a key goal is to make urine more alkaline (or basic, with a higher pH). This is often done with medications called potassium citrate or sodium bicarbonate.
- Diet Changes. Nutrition is an important part of uric acid kidney stone prevention. These diet changes can help reduce the risk of uric acid kidney stones:
- Drink plenty of fluids. Most people with kidney stones should aim for 100 fluid ounces per day.
- Avoid too much protein from meat, poultry, fish and seafood. This can help lower urine acid levels. Ask your dietitian how much protein is right for you.
- Eat at least 5 servings of fruits and vegetables per day. This can also help lower urine acid levels.
- Limit added sugar, especially from sugary drinks with high fructose corn syrup.
- Eat 2-3 servings of low-fat or fat-free dairy per day.
- Limit alcohol, especially beer.
Plant sources of purines, such as soy and legumes, have not been shown to increase the risk of uric acid kidney stones. Focus on limiting purines from red and processed meats, poultry, pork, fish, seafood and alcohol.
Making Sure Treatment Is Working
Your doctor will order x-rays, ultrasounds and/or CT scans to check on the size and location of your uric acid kidney stones. Sometimes, uric acid kidney stones can be dissolved by alkalizing your urine.
Your doctor may recommend a 24-hour urine test to measure urine pH, uric acid and total urine volume.
Questions to ask your healthcare team
- Should I take prescription potassium citrate or sodium bicarbonate?
- Do I need to have surgery to remove my kidney stones?
- Can I get a 24-hour urine test to figure out a better plan for stone prevention?
- Can you refer me to a kidney stone dietitian to help make diet changes to prevent more kidney stones?
- What urine pH should I aim for?
