Both diet and fluid intake can play a significant role in the pathogenesis of kidney stones. Evidence from large perspective studies has shown that an increased total fluid intake compared to low intakes was associated with a decreased risk of kidney stone formation (Curhan et al., 2004, Taylor et al., 2004).
The European Association of Urology recommends increasing fluid intake independent of the type of stones to achieve a urine volume of more than 2L /day, in addition to other dietary and lifestyle advice risk factors as shown in the table.
|Fluid intake (drinking advice)||
|Nutritional advice for a balanced diet||
|Lifestyle advice to normalise general risk factors||
Caution: Protein need is age-group dependent; therefore, protein restriction in childhood should be handled carefully.
Drinking water not only prevents the formation of kidney stones but it also has a cost-effectiveness in the healthcare system. Cost-effectiveness is the balance between what it costs to intervene and what would be achieved in terms of better outcomes. According to an analytical model applied by Lotan et al., (2012), if 100% of the French population drink 2L per day of water, this would result in an annual prevention of 9265 kidney stones, with an associated € 273 million cost saving for the national healthcare system.
Curhan GC, Willett WC, Knight EL, Stampfer MJ. Dietary Factors and the Risk of Incident Kidney Stones in Younger Women: Nurses' Health Study II. Arch Intern Med. 2004;164(8):885–891. doi:10.1001/archinte.164.8.885.
Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol. 2004;15(12):3225-32. doi: 10.1097/01.ASN.0000146012.44570.20. PMID: 15579526.
Lotan Y, Buendia Jimenez I, Lenoir-Wijnkoop I, Daudon M, Molinier L, Tack I, et al. Primary prevention of nephrolithiasis is cost-effective for a national healthcare system. BJU Int. 2012;110(11 Pt C):E1060-7.