Drinking more fluids can help lower your risk of kidney stones. The goal is to increase the amount of urine that flows through your kidneys and also to lower the concentrations of substances that promote stone formation. While you can vary the types of beverages you drink, sugar-sweetened beverages (such as soda and sports drinks) actually seem to increase the risk of kidney stones; they have other negative health effects as well and should therefore be avoided.
A high urinary volume is essential for the prevention of kidney stones. The average 24-hour urinary volume in normal individuals is about 1,300 ml per day or roughly 3 pints. Patients with kidney stones are asked to drink sufficient water to produce at least 2,000 mL or 2 liters of urine a day or more, which is slightly over a half-gallon or 4 pints. A low urinary volume will significantly increase the concentration of calcium, salt, and other minerals predisposing the patient to new kidney stone formation. The easiest way to correct this is to increase oral fluid intake, which is often difficult for many patients.
Clinicians should suggest that at least one-half of all new oral fluid intake should be water. Patients should avoid using electrolyte sports drinks and similar products to increase urinary output as they contain too much salt (sodium). Cranberry juice is not recommended in excess due to its moderately high oxalate content. If a patient likes cranberry juice, a glass or two is not a problem, but increasing it beyond moderate levels is not recommended. A good substitute for water is lemonade made with real lemon juice because lemon juice is high in citrate, a natural stone-preventing agent. The majority of any extra fluid ingested will increase the patient's urinary volume because all of the necessary, obligatory bodily requirements for fluids are already satisfied.
The patient's urine should appear no darker than a very pale yellow as a general rule. To help keep track of the 24-hour urinary volume, it is recommended that once a month, the patient should record their 24-hour urine output by measuring it in a urinal or collection hat and then adding up the totals for a 24-hour period. This makes it easy to compare to the optimal recommended levels. Specific gravity can measure urinary concentration. Optimal urinary specific gravity readings should consistently be 1.005 or less.
Substitute high-fluid content desserts, such as frozen ices, sherbet, melons, grapes, and fruit, in place of pastries, cookies, and cakes.
Maintain the humidity level between 40% and 45% in the home and workplace to minimize insensible fluid loss through the skin and normal respiration.
Limit salt and sodium intake, as excessive salt intake can increase fluid retention and make the urine more concentrated.
References:
Borghi L, Meschi T, Schianchi T, Briganti A, Guerra A, Allegri F, Novarini A. Urine volume: stone risk factor and preventive measure. Nephron. 1999;81 Suppl 1:31-7. doi: 10.1159/000046296. PMID: 9873212.
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- An increase in urine volume induced by a high water intake produces favourable effects on the crystallization of calcium oxalate and does not reduce the activity of natural inhibitors.
- A sufficiently high intake of water and probably other fluids such as coffee, tea, beer and wine has a preventive effect on nephrolithiasis and its recurrence.
- The role of fruit juice is still to be defined.
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A low urine volume must be considered as a real risk factor, both as regards the onset of renal calculi and stone relapses.
A major risk factor for kidney stones is constant low urine volume. Low urine volume may come from dehydration (loss of body fluids) from hard exercise, working or living in a hot place, or not drinking enough fluids.
When urine volume is low, urine is concentrated and dark in color. Concentrated urine means there is less fluid to keep salts dissolved. Increasing fluid intake will dilute the salts in your urine. By doing this, you may reduce your risk of stones forming.
Adults who form stones should drink enough fluid to make at least 2.5 liters (2/3rd gallon) of urine every day. On average, this will take about 3 liters (100 ounces) of fluid intake per day. While water is likely the best fluid to drink, what matters most is getting enough fluid.
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