WASHINGTON (dpa-AFX) - A major new study suggests that simply encouraging people to drink more water may not be enough to prevent kidney stones from recurring.
Researchers from the RTI-University of North Carolina Evidence-Based Practice Center set out to assess the benefits and risks of different strategies, including diet, medications, and surveillance imaging, for preventing recurrent kidney stones. Their analysis included 31 clinical studies involving mostly non-pregnant adults, along with a small number of children.
In one of the trials, participants were randomly assigned to receive either standard care or a structured behavioral hydration program. This program used a combination of tools such as Bluetooth-enabled smart water bottles to monitor fluid intake, personalized hydration goals, reminder text messages, financial incentives, and health coaching to encourage people to drink more fluids. Each fluid prescription was based on the individual's usual urine output and the additional fluid needed to reach a daily target of at least 2.5 litres.
While participants in the program did increase both their fluid intake and urine output, the improvement was not enough to significantly reduce the overall rate of symptomatic kidney stone recurrence. The findings also indicated that certain measures may still help lower the risk of recurrence, such as maintaining adequate water intake, following diets with normal to high calcium but low sodium and animal protein, and using medications such as thiazides, alkali therapy, and allopurinol, particularly for adults with calcium oxalate or calcium phosphate stones. However, the overall strength of the evidence remains limited.
According to the researchers, these results highlight the need for more effective prevention strategies, focusing on highly individualized hydration plans, addressing real-world barriers such as work routines and daily habits, and developing therapies that help keep minerals dissolved in urine.
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