Dietary changes including increased fluid intake are among recommendations in ACPs new evidence-based guideline.
People who have had a kidney stone should increase their fluid intake to achieve at least two liters of urine per day to prevent a recurrence, according to a new evidence-based clinical practice guideline from the American College of Physicians (ACP) being published in Annals of Internal Medicine.
A kidney stone occurs when tiny crystals in urine stick together to form a stone. About 13 percent of men and 7 percent of women in the U.S. will develop a kidney stone during their lifetime. Without treatment, up to 50 percent of those people will have a recurrence within five years. Researchers reviewed published literature from 1948 to March 2014 to inform ACPs guidelines. If increased fluid intake fails to reduce the formation of stones, medication or dietary changes may help. The evidence supports the use of medications such as thiazide diuretics, citrate, or allopurinol. Reducing dietary oxalate (found in chocolate, beets, nuts, rhubarb, spinach, strawberries, tea, and wheat bran), reducing dietary animal protein and purines, and maintaining normal dietary calcium may also help to prevent stone recurrence. The evidence also showed that patients who decreased intake of soda that was acidified by phosphoric acid (found in colas) had reduced kidney stone recurrence.
Article: Dietary and Pharmacologic Management to Prevent Recurrent Nephrolithiasis in Adults: A Clinical Practice Guideline From the American College of Physicians, A. Qaseem, P. Dallas, M.A. Forciea, M. Starkey, and T. Denberg, Annals of Internal Medicine, published 3 November 2014.