Kidney stone disease remains a growing health concern worldwide, with metabolic, inflammatory, and lifestyle factors all contributing to risk. New research now suggests that individuals with rheumatoid arthritis (RA) may be particularly vulnerable. In a large population-based study involving nearly 20,000 participants, researchers found that patients with RA experienced more than double the incidence of kidney stones compared to those without the condition. The association persisted even after adjusting for common risk factors such as age, sex, and comorbidities, highlighting a potential link between systemic inflammation and stone formation. Rheumatoid arthritis is a chronic autoimmune disease characterized by persistent joint inflammation and systemic immune dysregulation. Researchers propose several possible mechanisms that could explain the elevated risk of nephrolithiasis in RA patients. Chronic inflammation may alter calcium and uric acid metabolism, leading to increased urinary excretion and crystal deposition. Additionally, medications frequently used in RA management—such as corticosteroids and diuretics—may contribute to stone formation by influencing fluid balance and renal handling of minerals. Reduced physical activity and dietary modifications in RA patients could also indirectly affect risk. Importantly, the study’s design limited causal inference. While the findings underscore a significant association, they do not establish that RA directly causes kidney stones. Instead, the results suggest that RA may act as a clinical marker of increased susceptibility, requiring further mechanistic and longitudinal research to clarify causality. Clinically, these findings carry important implications. Physicians caring for RA patients should be aware of the heightened risk of nephrolithiasis and consider proactive monitoring, especially in individuals with additional metabolic risk factors. Lifestyle strategies such as hydration, balanced diets, and metabolic screening may help mitigate risks. Overall, the study highlights the broader systemic burden of RA beyond joint disease, adding kidney stones to the list of potential comorbidities requiring integrated care. Yue, G., Yan, Y., Zeng, X. et al. Association between rheumatoid arthritis and kidney stones: A cross-sectional study of NHANES 2007–2020. Arthritis Res Ther 27, 141 (2025). https://doi.org/10.1186/s13075-025-03604-w