If you have gout, you already know how painful uric acid crystals can be in a joint. The same substance can also crystallise in the urine and form kidney stones. This article explains how the two conditions are linked, how common stones are in gout, why uric acid stones can often be dissolved, which tests are used and how to lower your risk.
How gout and kidney stones are connected
Uric acid is a waste product made when the body breaks down purines, which MedlinePlus says are high in foods such as red meat, organ meats and some seafood. MedlinePlus explains that uric acid builds up when the body makes too much or the kidneys remove too little. In the joints it can form needle-shaped crystals, which cause gout. In the urine it can crystallise into stones.
The NHS describes gout as caused by too much uric acid in the blood, and lists kidney stones among the complications of repeated, untreated attacks. The link also runs through urine acidity: a 2015 meta-analysis in Arthritis Research & Therapy notes that gout is associated with lower urine pH, which in theory favours stone formation.
How common are stones in people with gout?
Stones are more common in people with gout than in people without it. The meta-analysis above found that, across eight studies, about 14% of people with gout said they had had a kidney stone at some point, and that gout remained independently linked to stones after other factors were taken into account.
Many stones may go unnoticed. In a study of 140 people with gout published in The Journal of Rheumatology, 39% had stones, and about a third of these were found only on ultrasound rather than from past symptoms. The authors concluded that the true number of stones in gout is likely higher than previously reported. In that study, more acidic urine was the factor that differed between people with and without stones.
Why uric acid stones are different
According to the National Kidney Foundation, uric acid stones form when urine is too acidic, and they make up about 7% of kidney stones. Besides gout, it lists diabetes, obesity, metabolic syndrome, diets heavy in red and processed meat, and frequent dehydration as risk factors. The EAU 2026 urolithiasis guidelines also include gout among the causes of uric acid stones.
Not every stone in a person with gout is uric acid; calcium stones also occur. Knowing the type changes treatment, which is why stone analysis matters. See stone types and stone analysis, and for the metabolic side, diabetes, obesity and kidney stones.
Can uric acid stones dissolve?
Often, yes. The National Kidney Foundation explains that uric acid stones may dissolve when urine is made less acidic with medicine. The EAU 2026 guidelines describe this as oral chemolysis and state that urine pH should be adjusted to 7.0 to 7.2. They also warn that a higher pH may lead to calcium phosphate stones, so the balance needs care.
- The doctor chooses the medicine and adjusts it to your urine pH; it should not be started on your own.
- The EAU recommends that patients are taught to check their urine pH with a dipstick at home.
- Follow-up imaging confirms whether the stone is shrinking.
Dissolving is not suitable for every situation. A stone that is blocking the kidney, causing infection or severe pain, or not responding may need removal. The National Kidney Foundation mentions shock wave lithotripsy and ureteroscopy for stones that do not pass or dissolve. The centre offers flexible ureteroscopy with laser, and the stone treatment page compares options.
Tests your doctor may arrange
| Test | What it tells your doctor |
|---|---|
| Blood uric acid | Whether uric acid is raised; MedlinePlus notes it helps diagnose gout |
| 24-hour urine collection | Urine volume, pH and uric acid; MedlinePlus notes it can show whether high uric acid is causing stones |
| Urine test and urine pH | Blood, infection and how acidic the urine is |
| Imaging (ultrasound, X-ray or CT) | Size and position of stones; the National Kidney Foundation lists X-rays, ultrasound and CT scans for uric acid stones |
| Stone analysis | The exact stone type, which guides prevention |
MedlinePlus adds that a high uric acid result does not always mean you need treatment; your doctor interprets it alongside your symptoms and history.
When to seek urgent care
Get emergency help the same day if you have:
- severe pain in the side, back or groin that does not settle
- fever or chills with stone pain, which the National Kidney Foundation says can be signs of infection needing urgent care
- vomiting that stops you keeping fluids down
- very little or no urine
The main guide to kidney and ureteric stones covers general stone symptoms.
Preventing stones if you have gout
Prevention aims to lower uric acid where needed, keep urine dilute and avoid very acidic urine:
- Drink plenty of fluids: the National Kidney Foundation advises drinking enough to produce at least 2.5 litres of urine a day.
- Take prescribed treatment regularly: the NHS says uric acid-lowering medicine should be taken regularly, even when you have no symptoms.
- Watch purine-rich foods: the National Kidney Foundation advises avoiding too much protein from meat, poultry, fish and seafood, and eating plenty of fruit and vegetables. It notes plant purines, such as legumes, have not been shown to raise risk.
- Limit alcohol and sugary drinks, as both the NHS and the National Kidney Foundation advise.
- Lose weight gradually if needed; the NHS advises against crash diets.
Heat and sweating also concentrate urine; see kidney stones in hot weather. A urologist can assess your stones and work with the doctor who manages your gout.
Frequently asked questions
Can gout cause kidney stones?
Yes. The NHS lists kidney stones among the complications of repeated, untreated gout attacks. A 2015 meta-analysis in Arthritis Research & Therapy found that about 14% of people with gout reported a kidney stone, and that gout was independently linked to stones. Acidic urine is a key reason.
Can uric acid kidney stones dissolve without surgery?
Often, yes. The National Kidney Foundation explains that uric acid stones may dissolve when urine is made less acidic with medicine. The doctor chooses and adjusts this treatment using urine pH checks. Stones that block the kidney, cause infection or do not respond may still need a procedure.
Does high uric acid always mean I will get kidney stones?
No. MedlinePlus states that not everyone with high uric acid develops gout or kidney stones, and a high result does not always mean treatment is needed. Urine acidity, how much you drink, diet and other conditions also affect your risk, so your doctor looks at the whole picture.
What foods should I avoid with gout and kidney stones?
The National Kidney Foundation advises avoiding too much protein from meat, poultry, fish and seafood, and limiting alcohol and drinks with added sugar. It recommends plenty of fruit and vegetables. Your doctor or dietitian can tailor advice once your stone type and urine results are known.
How are uric acid stones diagnosed?
Diagnosis uses imaging such as ultrasound or CT, plus urine and blood tests. The National Kidney Foundation notes that a 24-hour urine collection measures urine pH, uric acid and volume. Analysing a passed or removed stone confirms the type.
References
- Gout – NHS
- Uric Acid Test: MedlinePlus Medical Test
- Uric Acid Kidney Stones: Symptoms, Treatment, & Prevention | National Kidney Foundation
- EAU Pocket Guidelines on Urolithiasis 2026
- Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies
- Prevalence and risk factors for urolithiasis in primary gout: is a reappraisal needed?
Book a consultation
Prof. Samir Al-Samarrai and Dr. Amer Mousa assess urological conditions at Prof. Al-Samarrai Medical Center, Dubai Healthcare City, and discuss the options that suit your case. Medical consultations are confidential.
Read more: Urologist in Dubai: doctors, services, insurance and booking
This information is for health education and does not replace a medical examination. See our medical content policy.
Medically reviewed by: Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. Review date: .
About the doctor
Prof. Dr. Samir Ahmed Al-Samarrai, consultant urologist. He studied medicine at the universities of Heidelberg and Johannes Gutenberg in Germany and graduated with distinction, earned his doctorate (PhD) with a research thesis in 1980, and on 23 August 1978 received his specialist certificate in the treatment and surgery of male urological diseases from the Free University of Berlin, at its medical school hospital, under the specialist regulations of the Berlin Chamber of Physicians.
Clinic: Prof. Al-Samarrai Medical Center, Al Razi Medical Complex 64, Building D, 2nd floor, No. 2018, Dubai Healthcare City, Dubai. MOHAP licence: ZGU3I12X-291225.
This article is for health education and does not replace a consultation with a doctor. Last updated: 6 November 2026.
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