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Measures to prevent recurrence of renal or ureteric stones

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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:

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