diet and lifestyle measures to prevent recurrence of renal or ureteric colic
Last edited 04/2020 and last reviewed 03/2023
Dietary and lifestyle advice
Advice regarding diet and fluid intake::
- adults to drink 2.5 to 3 litres of water per day, and children and young people (depending on their age) 1 to 2 litres
- adding fresh lemon juice to drinking water
- avoiding carbonated drinks
- adults to have a daily salt intake of no more than 6 g, and children and young people (depending on their age) 2 to 6 g
- not restricting daily calcium intake, but maintaining a normal calcium intake of 700 to 1,200 mg for adults, and 350 to 1,000 mg per day for children and young people (depending on their age).
- avoid excess dietary protein, as this acidifies urine and promotes hyperuricosuria, predisposing to stone development (2)
Potassium citrate
- alongside the recommendations on dietary and lifestyle advice
- potassium citrate should be considered for adults with a recurrence of stones that are predominantly (more than 50%) calcium oxalate
- potassium citrate should be considered for children and young people with a recurrence of stones that are predominantly (more than 50%) calcium oxalate, and with hypercalciuria or hypocitraturia.
Thiazides
- alongside the recommendations on dietary and lifestyle advice
- thiazides should be considered for adults with a recurrence of stones that are predominantly (more than 50%) calcium oxalate and hypercalciuria, after restricting their sodium intake to no more than 6 g a day
Notes:
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metabolic testing
- stone analysis should be considered for adults with ureteric or renal stones
- measure serum calcium for adults with ureteric or renal stones
- consider referring children and young people with ureteric or renal stones to a paediatric nephrologist or paediatric urologist with expertise in this area for assessment and metabolic investigations
Reference:
- NICE (December 2018).Renal and ureteric stones: assessment and management (NG118)
- Wilcox CR et al. Kidney stone disease: an update on its management in primary care. BJGP 2020; 70: 205–206.