diet and fluid advice to prevent recurrence of renal or ureteric stones

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:

  • 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:

Related pages:

renal stones

renal colic