Drinking Enough Water to Prevent Kidney Stones is Difficult, Even With Support

Duke researchers find hydration programs help, but new approaches are needed to prevent painful recurrences

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This is a summary of a press release from Duke Health News.

Drinking more water is one of the most common recommendations for preventing kidney stones. But a new Duke-led study suggests it may not be as simple as it sounds.

Kidney stones affect about 1 in 11 people in the United States, and nearly half will experience them again. To understand whether various supports could help patients meet their prescribed water drinking goals, researchers conducted the largest behavioral study of its kind, tracking more than 1,600 participants over two years.

The results were mixed. While people in the program did drink more water, it wasn’t enough to significantly reduce recurrence across the group.

“The trial results show that achieving and maintaining very high fluid intake is more challenging than we often assume,” said Dr. Charles Scales, associate professor at Duke University School of Medicine and co-senior author of the study.

Even with strong motivation and daily support, many participants struggled to meet hydration targets. Researchers say this may help explain why kidney stones often come back, despite clear medical advice to drink more fluids.

The federally funded study is the first to track actual stone recurrence, not just water intake, using imaging and surveys over time. That distinction allowed researchers to measure what truly matters: whether patients developed new stones or existing ones worsened.

“Rather than asking every patient to meet the same fluid goal, we should determine who benefits from which targets,” said Dr. Gregory Tasian, co-senior author of the study at Children’s Hospital of Philadelphia.

The results also point to the need for new approaches beyond hydration alone, including treatments that help keep minerals dissolved in urine and strategies that make it easier for people to maintain consistent habits.

Learn more about how federally funded Duke Research Saves Lives in the full story at Duke Health News.