Water & Hydration for Kidney Stone Prevention

Hey, this is Kyle Wood

with the Kidney Stone Collaborative.

I’m an associate professor at the University of Alabama

and specialize in kidney stones.

There was a question brought up about whether

what else can be done outside of drinking more fluids

for kidney stone prevention.

So I’m just gonna take a few minutes to discuss that.

Whenever you have a kidney stone,

we do focus on fluid intake and we do recommend 96 ounces.

That really comes from a study that showed that

you could reduce your stone risk as much as 60%.

When you looked at stone formers

and you followed ’em for roughly five years,

and when we looked at the amount

of fluids they were taking in,

they were taking in about 96 ounces to have, uh,

urine output, about 2.5 liters.

And so we really do focus on fluids

and patients always ask me,

what fluids should I be focused on?

Order’s, probably the best fluid to take in,

but if you look at the large epidemiological studies stone,

uh, decrease in stone risk occurs if you drinking coffee,

um, um, even with alcohol.

Not that I recommend drinking any alcohol,

but there are some of the fluids that might want

to be avoided would be some of the almond based

or nut-based milks, as they may contain high oxalates

and really should avoid sodas.

I tell patients that they’re gonna consume sodas, try

to stick with the clear sodas,

and then obviously you want to be cognizant

of your caloric intake.

So anything that has high calorie, um, such as some juices

and stuff you want to be cautious of taking, uh,

high calories in as stones have been associated

with obesity and gaining weight.

So the other thing that may help is if you want

to add something to your fluids, such as a citrate powder.

So crystal light is a good option,

and that might be that might, that has been shown

to potentially decrease stone risk

or at least help with some

of the stone parameters like increasing your citrate.

Other ways through which you can decrease your stones is

really focusing on your salt intake.

We really try to recommend 2000 milligrams

or less of, uh, sodium intake,

and that can be helpful for stone disease,

but also cardiovascular issues as well.

Salt comes in many forms

and I tell patients that it’s not usually due to the salt

that you’re adding to your foods.

It is due to the salt within the food that you’re eating.

So being cognizant of that

and looking on your boxes, looking at your prepared foods

and trying to avoid high salt intake can help

with stone prevention.

The mechanism through which this works is it really reduces

your urinary calcium excretion.

We know that in almost all stone formers, um,

calcium based stone formers, cysteine stone formers,

the more salt you take in, the more calcium

or cysteine you release into your urine.

And so reducing your salt intake will help reduce your

calcium in your urine and help prevent calcium stones.

We also, in general, tell people to try

to focus on taking in more fruits and vegetables.

The American diet is high in protein

and does not have a, uh, good amount of fruits

and vegetables usually within that diet.

If you take in more fruits and vegetables, this adds citrate

and that can help with prevention of kidney stones,

citrates, and known inhibitor of kidney stones,

and that comes with also reducing your protein intake.

Um, for most Americans,

they do have very high protein intake, so in general terms,

focusing on more fruits and vegetables

and less protein that can help with stone prevention.

So overall, the dietary advice is increasing your fluids,

decreasing your salt, increasing your fruits and vegetables,

and decreasing your protein intake.

The caveat to all of this is a is an individualized plan

and every patient should stone patient should talk

to their doctor about their individualized

needs when it comes to diet and fluid management.

Take care.