A major study finds that simply encouraging people to drink more water may not be enough to stop kidney stones from coming back.
Kidney stones are small, hard mineral deposits, but the pain they cause can be overwhelming. They often strike suddenly, interrupt daily life, and send people to the emergency room. In the United States, about 1 in 11 people will develop a kidney stone, and nearly half will have another one later.
Because stones often return, prevention matters as much as treatment. A major new study from the Urinary Stone Disease Research Network, coordinated by the Duke Clinical Research Institute, tested whether a behavioral program could help people drink enough fluid to lower that risk.
Published in The Lancet, the research sheds light on why preventing kidney stones remains difficult, even among individuals who are motivated and receive ongoing support.
“The trial results show that despite the importance of high fluid intake to prevent stone recurrence, achieving and maintaining very high fluid intake is more challenging than we often assume for people with urinary stone disease,” said Charles Scales, M.D., corresponding and co-senior author of the paper and associate professor in the departments of Urology and Population Health Sciences at Duke University School of Medicine.
“The challenge of adherence likely contributes to the relatively high rate of stone recurrence in people with this chronic condition,” Scales said.
Inside the Behavioral Hydration Program
Participants were randomly assigned to either standard care or a behavioral hydration program. This program included Bluetooth-enabled smart water bottles to track fluid intake, personalized hydration goals (“fluid prescriptions”), financial incentives, reminder text messages, and health coaching to encourage increased fluid consumption.
