Successfully passing a kidney stone thanks to effective lithotripsy treatment is a relief, but the journey doesn’t end there. About 1 in 10 people in the U.S. will experience a kidney stone at some point in their life; lifetime risk estimates commonly cited are roughly 9% for women and 19% for men. (Note: Point-prevalence estimates vary by study and have been rising over recent decades.) If you’ve had one stone, you’re at higher risk for developing another. The good news is that dietary changes can significantly reduce your chances of recurrence.
Hydration: Your First Line of Defense
Aim for a urine output of about 2-2.5 L/day (clinically recommended target for many stone formers). That typically means drinking at least 8-12 cups of fluid daily, more with heat or exercise; adjust so your 24-hour urine volume stays in that 2-2.5 L range.
The Calcium Paradox
Contrary to popular belief, calcium isn’t the enemy when it comes to calcium-based kidney stones. A diet low in calcium actually increases your chances of developing kidney stones. Consume about 1,000–1,200 mg calcium/day from food (dairy or calcium-rich foods). Dietary calcium helps bind intestinal oxalate and is protective; calcium supplements may increase stone risk if taken without food, so discuss supplements with your clinician. Good options include milk, yogurt, cheese, calcium-fortified juices, cereals, and certain vegetables.
When you eat calcium-rich foods together with oxalate-rich foods during a meal, the oxalate and calcium are more likely to bind to one another in the stomach and intestines before entering the kidneys, making it less likely that kidney stones will form.
Watch Your Sodium Intake
Extra sodium causes you to lose more calcium in your urine. Sodium and calcium share the same transport in the kidney, so if you eat high sodium foods it will increase calcium leakage in the urine. If tests show high urinary calcium, your clinician may advise aiming lower than 2,300 mg/day (for example ~1,500 mg/day).
Moderate Your Protein
High-protein diets can raise uric acid and lower the amount of citrate in the urine, contributing to stone formation. Limit animal proteins like beef, chicken, pork, fish, and eggs to about 6 to 8 ounces per day. That’s roughly the size of a deck of cards.
Navigate the Oxalate Challenge
For those who form calcium oxalate stones (the most common type), managing oxalate intake requires strategy rather than elimination. High-oxalate foods include peanuts, rhubarb, spinach, beets, Swiss chard, chocolate, and sweet potatoes. Rather than avoiding these nutritious foods entirely, pair them with calcium-rich options to help prevent stone formation.
Add Citrate-Rich Foods
Lemonade made from real lemons is high in citrate, which may help prevent kidney stones. Other citrus fruits like oranges also provide this natural stone inhibitor.
The Bottom Line
There’s no one-size-fits-all approach to kidney stone prevention. Your dietary plan should be tailored to your specific stone type and risk factors. Consider consulting with a registered dietitian who specializes in kidney stone prevention to develop a personalized eating plan that works for your lifestyle.
If you’re struggling with kidney stones, lithotripsy may be your solution! Give us a call at (919) 404-7255 or fill out our contact form here.