Kidney stones: Water panacea no more

A study says treatment needs to be beyond mere hydration

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MOST PEOPLE WITH kidney stones are advised high fluid intake. But a recent study indicates that it might not be as simple, indicating that hydration alone might not work, or adequate hydration might not be happening. So what are the current guidelines for kidney stones apart from hydration?

Dr Shyam Varma, robotic urologist and renal transplant surgeon, Kokilaben Dhirubhai Ambani Hospital, Andheri, says: "For decades, the advice for kidney stone sufferers has been simple: drink more water. But a landmark study published this month in 'The Lancet' suggests it is not that straightforward. While high fluid intake remains crucial, researchers from Duke University found that even with strong motivation and daily support, maintaining the very high fluid levels needed to prevent stones is far more challenging than previously assumed for many patients.

Beyond drinking 2.5 to 3 litres of water daily, current medical guidelines emphasise a multi-pronged approach:

Dietary modifications:

Reduce sodium (salt), limit animal protein, and avoid excessive oxalate-rich foods like spinach and nuts. Surprisingly, adequate dietary calcium (from food, not supplements) is now recommended as it binds oxalate in the gut.

Metabolic evaluation: