Objective:

To evaluate the effectiveness of increased fluid intake, dietary modifications, and pharmacologic therapies in preventing recurrent kidney stones in adults.

Approach:

Key Findings:

• Increased fluid intake to achieve a urine volume of at least 2 L/day may reduce stone recurrence.
• A normal- to high-calcium diet lower in protein and sodium may lower recurrence rates compared to low-calcium diets.
• Pharmacologic therapies such as thiazides, alkali therapy, and allopurinol showed low-strength evidence of benefit.
• Most studies had high or serious risk of bias, and evidence quality was mostly low.

Interpretation:

While increased fluid intake and dietary modifications may help reduce kidney stone recurrence, the overall evidence is limited and should be interpreted with caution due to biases in the studies.

Limitations:

• Most studies had important limitations and high risk of bias.
• Pediatric data were sparse.
• No studies evaluated surveillance imaging strategies.

Conclusion:

Increased fluid intake, targeted dietary modifications, and selected pharmacologic therapies may help reduce recurrence or stone growth in adults with calcium-based stones, but further research is needed.

Sources:

• Annals of Internal Medicine
Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.