Ann Intern Med
Diet and common medications may curb recurrent kidney stones, but evidence remains limited
In a systematic review of 31 studies (mostly randomized trials), increased fluid intake; a diet with normal to high calcium, low protein, and low sodium; thiazide diuretics; alkali therapy; and allopurinol were associated with lower recurrence of calcium oxalate or calcium phosphate stones in adults, although strength of evidence was low. Selective, stone-based pharmacotherapy didn't clearly differ from empiric therapy. Acetohydroxamic acid was associated with reduced growth of infection-related stones but to more adverse events. Data were sparse for children, imaging strategies, and harms overall.
Clinical takeaway: For adults with recurrent calcium-based stones, prioritize counseling on high fluid intake, sodium and protein reduction with adequate dietary calcium, and consider thiazides, alkali therapy, or allopurinol based on stone type and risk profile.
Source:
Asher GN, et al. (2026, March 24). Ann Intern Med. Prevention of Recurrent Nephrolithiasis in Adults and Children : A Systematic Review. https://pubmed.ncbi.nlm.nih.gov/41871357/
