How to Prevent Kidney Stones: With or Without a Previous History

The likelihood of having repeat kidney stones after treatment is 50%

Kidney stones aren't entirely preventable, but you can take steps to reduce your risk. Drinking plenty of fluids (ideally water) is arguably the best way to prevent kidney stones—or to avoid recurrence if you've had them before. Other key measures include adding calcium to your diet and reducing your intake of sodium, animal protein, and foods rich in oxalate.

This article explains why kidney stones can be difficult for some people to avoid. It also describes 10 ways to prevent kidney stones and remedies that may help dissolve stones if you have them.

A person eats a bowel of oatmeal at home while looking at laptop

Dejan_Dundjerski / Getty Images

The Uncontrollable: Why Kidney Stone Prevention Isn’t Completely Possible

Kidney stones, also known as renal calculi or nephrolithiasis, have become increasingly common in the United States. This is largely due to the traditional Western diet, which involves overconsumption of salt and animal protein and inadequate intake of fruits, vegetables, and water.

Back in the 1970s, roughly 1 out of 25 people in the United States developed kidney stones during their lifetime. Today, that number has risen to 1 out of 10. While older adults are most affected, children have become increasingly vulnerable to nephrolithiasis.

To complicate matters further, people who have had kidney stones in the past are at high risk of getting them again.

According to a 2022 study published in BMC Urology, nearly half of all people with kidney stones will experience another episode within 10 years, while 10% will experience multiple episodes. The recurrence rate for children with kidney stones is 50% within three years.

Many different factors—some able to be changed and others not—contribute to the risk of kidney stone recurrence, including:

Of the four types of kidney stones a person can get—calcium oxalate, uric acid, struvite, and cystine—people who develop a uric acid stone are more likely to experience recurrence, according to a 2022 study in BMC Urology.

What You Can Do to Prevent Kidney Stones

A kidney stone is made up of waste products in your urine. When there is too much waste and too little fluid, the waste can start to crystallize and grow into a solid "stone" that is passed out of the body when you urinate (pee). The stone-forming chemicals include calcium, oxalate, urate (uric acid), cystine, xanthine, and phosphate.

The prevention of kidney stones is largely focused on avoiding the accumulation of these minerals and chemicals in your urine.

Here are 10 ways to do so.

Drink More Water

Drinking enough liquid, mainly water, is the most important thing you can do to prevent kidney stones, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Many healthcare providers recommend that you drink six to eight 8-ounce glasses of water per day. Doing so dilutes your urine and prevents the crystallization of waste products that can lead to kidney stones.

If you physically exert yourself or have symptoms of dehydration, you may need to drink even more. Speak with your healthcare provider to determine the right amount for you.

According to the American Urological Association, people who have experienced a kidney stone in the past should drink enough fluid to produce 2.5 liters (or roughly 10 cups) of urine each day.

Cut Back on Oxalate-Rich Food

Oxalate is a natural compound found in vegetables, fruits, nuts, and grains. When you eat oxalate, it typically binds to calcium in the intestine and leaves the body in stool.

But if there is not enough calcium to bind to, it will be absorbed into the bloodstream and end up in the urine, where it can form into a calcium oxalate stone (the most common type of kidney stone).

To reduce the risk of kidney stones or kidney stone recurrence, limit your intake of foods especially high in oxalate. These include:

  • Tree nuts and nut products
  • Peanuts
  • Rhubarb
  • Spinach
  • Wheat bran
  • Rice bran
  • Cocoa powder
  • Black tea
  • Tofu
  • Sweet potatoes

Reduce Your Sodium Intake

When you eat too much salt (sodium), the body will get rid of it in urine. When this happens, the excreted sodium will take calcium with it, causing calcium levels to drop. This can lead to the accumulation of oxalate in your urine, resulting in a kidney stone.

Adults in the United States are advised to consume less than 2,300 milligrams (mg)—or roughly 1 teaspoon—of sodium daily. These guidelines are especially important if you've had a calcium oxalate stone, even if you take medications to prevent kidney stones.

Check food nutrition labels, as sodium is found in many canned, packaged, and fast foods.

Get Enough Calcium From Food

By ensuring an ample intake of calcium in your diet, oxalate is more likely to be cleared from your body in stool rather than crystallizing in your urine.

In the United States, the recommended adult intake of calcium is 1,000 mg per day, increasing to 1,200 mg by age 70. The recommended intake for children ages 4 to 8 is 1,000 mg, increasing to 1,300 mg from ages 9 to 18.

While you can certainly get calcium from a dietary supplement. food remains the best source of this essential mineral. Calcium is especially high in:

  • Milk and other dairy products
  • Canned sardines and salmon with bones
  • Dark green vegetables like kale, broccoli, and bok choy
  • Calcium-fortified fruit juices, breakfast cereals, and tofu

Avoid High-Purine Foods

Shellfish, organ meats, and some other foods have high concentrations of a natural chemical compound called purine. Consuming too much purine can increase the levels of uric acid in your bloodstream and urine, leading to the formation of uric acid stones. Having these types of stones tends to run in families.

If you've had a uric acid stone or have a family history of them, you may need to limit your intake of high-purine foods such as:

  • Alcohol (all types)
  • Red meats, including beef, pork, veal, and venison
  • Organ meats, such as kidney, liver, and sweetbreads
  • Shellfish, such as scallops, crab, lobster, oysters, and shrimp 
  • Some fish, including anchovies, sardines, herring, haddock, and cod
  • Processed meat, such as ham and bacon

Eat Less Animal Protein

High-protein diets can increase your risk of kidney stones. This is especially true if you overconsume animal protein, which raises uric acid levels (increasing the risk of uric acid stones) and also promotes the elimination of calcium in your urine (increasing the risk of calcium oxalate stones).

A 2022 study in Advances in Nutrition reports that the overconsumption of red meat increases the risk of kidney stones by 39%. Moreover, the risk increases with every 100-gram (g), or 3.5-ounce, portion you eat during a meal.

Beef is considered the major contributor of calcium oxalate stones. Other red meats, chicken, and other poultry can also contribute, while fish is a less likely cause.

As an alternative to animal protein, you can eat protein-rich, nonanimal protein like beans, lentils, nutritional yeast, seitan, and spirulina, which are not associated with kidney stones.

How Much Protein Should I Eat?

The recommended daily intake of protein for a sedentary adult is 0.8 g per kilogram of body weight (g/kg). For a person weighing 165 pounds (75 kilograms), that would translate to roughly 60 g (2.1 ounces) per day.

Try the DASH Diet

The DASH (Dietary Approaches to Stop Hypertension) diet is an eating plan endorsed by the National Heart, Lung, and Blood Institute to prevent and manage high blood pressure. The DASH diet is high in calcium and rich in fruits, vegetables, whole grains, nuts, legumes, and low-fat dairy.

The DASH diet is cited by some as an effective, all-in-one dietary strategy for reducing the risk of kidney stones in at-risk individuals. A 2020 study in Clinical Nutrition ESPEN, a publication of the European Society for Clinical Nutrition and Metabolism (ESPEN), reported that the DASH diet was associated with a significant decrease in the urinary excretion of calcium and uric acid, reducing the risk of both calcium oxalate and uric acid kidney stones.

To build a sustainable DASH diet, ask your healthcare provider for a referral to a registered dietitian (RD) or registered dietitian nutritionist (RDN) who can help.

Be Careful With Vitamin C

As beneficial as vitamin C (ascorbic acid) is to your health, taking too many vitamin C supplements may increase your risk of kidney stones. This is because the metabolization (breakdown) of vitamin C in the liver results in the formation of oxalate.

Even the breakdown of 60 mg of vitamin C can result in 30 mg of oxalate in your bloodstream. Some studies suggest that vitamin C doses at or above 2,000 mg per day increase the risks of calcium oxalate stones by as much as 34%.

The recommended daily intake of vitamin C for adult females is 70 mg and 90 mg for adult males based on the U.S. Dietary Reference Intakes.

Lose Weight

Obesity, defined as a body mass index (BMI) of 30 or higher, is also linked to an increased risk of kidney stones. Not only is obesity associated with hypertension (a known risk factor for kidney stone recurrence), but it also increases the urinary excretion of uric acid and calcium.

Some studies report that just over 50% of people with obesity experience kidney stones (most commonly calcium oxalate stones).

While weight loss can significantly decrease the risk of kidney stones, certain weight loss drugs like Xenical (orlistat) and Qsymia (phentermine + topiramate) may increase the risk by binding to calcium and promoting the buildup of oxalate in urine.

Bring Your Blood Pressure Under Control

Hypertension is strongly linked to kidney stones. Although the exact cause of this is known, studies have shown that people with high blood pressure have over 20% greater excretion of uric acid, calcium, and oxalate in urine compared to people without high blood pressure.

While this is seen most commonly in people with hypertension and obesity, it can also occur in the absence of obesity.

Treating hypertension may help reduce the risk of kidney stones. This typically involves a low-fat diet, routine exercise, weight loss, and antihypertensive drugs when needed.

Do High Blood Pressure Medications Cause Stones?

While medications are sometimes needed to control blood pressure, drugs like angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers may increase the risk of kidney stones in older adults by promoting calcium excretion.

One class of antihypertensive drugs, called thiazide diuretics, is not associated with an increased risk of kidney stones and may be well-suited for people who also have recurrent nephrolithiasis.

Does Anything Dissolve Kidney Stones Fast?

Staying hydrated is one of the best ways to prevent kidney stones from forming. But even if you follow all of the rules, kidney stones can still sometimes develop. Genetics and other risk factors may predispose you to them.

If you are faced with a kidney stone—either one that causes symptoms or is detected on a computed tomography (CT) scan or other imaging study—you can try substances that may help dissolve them and make them easier to pass. They may even prevent kidney stones from happening.

Apple Cider Vinegar

Apple cider vinegar is a folk remedy still used today to help treat kidney stones. It contains a type of acid called acetic acid that changes the pH (acid-alkaline balance) of urine and impedes the formation of calcium oxalate, uric acid, and cystine crystals.

A preliminary study from China involving over 9,000 adults suggested that a 5% acetic acid solution taken daily by mouth was associated with a reduced risk of kidney stones.

Whether apple cider can actually dissolve kidney stones remains under debate.

A 2021 study published in BMC Urology looked at several organic substances popularly used to help pass kidney stones. Chief among them was apple cider vinegar, which failed to diminish the size or composition of a stone after 72 hours. The same was seen with other organic acids like citric acid (found in citrus fruits) and ascorbic acid (vitamin C).

How to Use Apple Cider Vinegar

A 5% solution can be made by mixing 2 tablespoons of apple cider vinegar with 6 to 8 ounces of water. At this dilution, side effects are uncommon, but taking more than this amount can reduce potassium levels in the body over time, leading to bone mineral loss.

Potassium Citrate

Potassium citrate is a type of potassium salt that also alters the pH of your urine to make it less acidic. Sold under the brand name Urocit-K and others, healthcare providers commonly prescribe potassium citrate to help restore the chemical balance of urine to prevent calcium oxalate stones or uric acid stones.

Some healthcare providers will also prescribe potassium citrate to help dissolve kidney stones so they are easier to pass.

Urocit-K is formulated as an extended-release tablet to be taken two to three times daily with food. Possible side effects include stomach ache, loose bowel movements, nausea, or vomiting.

After a Kidney Stone: Provider Follow-Up

After you've had a kidney stone, ongoing management may be needed given the high risk of recurrence.

As a general rule, healthcare providers will obtain a sample of the stone whenever possible to determine which type of stone it is and help establish the underlying cause.

After dietary guidelines and possible drug therapies (including thiazide diuretics and potassium citrate) are prescribed, routine urine testing is advised. This includes a 24-hour urine collection performed after six months and then annually to check that the composition and pH of your urine are normalized.

Blood testing may also be performed to avoid drug side effects. Periodic imaging studies, such as an abdominal ultrasound, an X-ray, or a computed tomography (CT) scan, may be ordered to check for new stone formation. This is especially true for people with a history of kidney stone recurrence or whose urine samples show little to no response to treatment.

Summary

Kidney stones recur in around 50% of people who get them. To prevent kidney stones from recurring, you may be advised to increase your intake of water and calcium-rich foods while reducing your consumption of animal protein, sodium, purines, and oxalate-rich foods. Weight loss and improved management of your blood pressure can also help.

There are also substances you can take, like apple cider vinegar or potassium citrate, that can help dissolve kidney stones or prevent them from returning.

24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Diabetes and Digestive and Kidney Diseases. Eating, drinking, and nutrition for kidney stones.

  2. Kok, DJ. The preventive treatment of recurrent stone-formation: how can we improve compliance in the treatment of patients with recurrent stone disease? Urolithiasis. 2016;44:83–90. doi:10.1007/s00240-015-0842-9

  3. Kidney Disease Foundation. Kidney stones.

  4. Wang K, Ge J, Han W, et al. Risk factors for kidney stone disease recurrence: a comprehensive meta-analysis. BMC Urol. 2022;22:62. doi:10.1186/s12894-022-01017-4

  5. Pearle MS, Goldfarb DS, Assimos DG, et al. Medical management of kidney stones: AUA guideline. J Urol. 2014;192:316.

  6. Ferraro PM, Taylor EN, Gambaro G, Curhan GC. Dietary and lifestyle risk factors associated with incident kidney stones in men and womenJ Urol. 2017;198(4):858-863. doi:10.1016/j.juro.2017.03.124

  7. Siener R. Nutrition and kidney stone disease. Nutrients. 2021;13(6):1917. doi:10.3390/nu13061917

  8. Office of Dietary Supplements. Calcium - fact sheet for health professionals.

  9. Arthritis Foundation. Which foods are safe for gout?

  10. Tracy CR, Best S, Bagrodia A, et al. Animal protein and the risk of kidney stones: a comparative metabolic study of animal protein sources. J Urol.. 2014;192(1):137-141. doi:10.1016/j.juro.2014.01.093

  11. Asoudeh F, Talebi S, Jayedi A, Marx W, Najafi T, Mohammadi H. Associations of total protein or animal protein intake and animal protein sources with risk of kidney stones: a systematic review and dose–response meta-analysis. Advances Nutrition. 2022;13(3):821-832. doi:10.1093/advances/nmac013

  12. Office of Disease Prevention and Health Promotion. Dietary Guidelines for Americans 2020-2025.

  13. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesHypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065

  14. Maddahi n, Aghamir SMK, Moddaresi SS, Mirzaei K, Alizadeh S, Yekaninejad MS, The association of Dietary Approaches to Stop Hypertension-style diet with urinary risk factors of kidney stones formation in men with nephrolithiasis. Clin Nutrition ESPEN. 2020;39:173-179. doi:10.1016/j.clnesp.2020.06.021

  15. Knight JK, Madduma-Liyanage K, Mobley JA, Assimos DG, Holmes RP. Ascorbic acid intake and oxalate synthesis. Urolithiasis. 2016;44(4):289–297. doi:10.1007/s00240-016-0868-7

  16. Poore W, Boyd CJ, Singh nP, Wood K, Gower B, Assimos DG. Obesity and its impact on kidney stone formation. Rev Urol. 2020;22(1):17–23.

  17. Kittannamongkolchai W, Mara KC, Mehta RA, et al. Risk of hypertension among first-time symptomatic kidney stone formers. Clin J Am Soc Nephrol. 2017 Mar 7;12(3):476–482. doi:10.2215/CJN.06600616

  18. Alexander R, McArthur E, Jandoc R, et al. Antihypertensive medications and the risk of kidney stones in older adults: a retrospective cohort studyHypertens Res. 2017;40:837–842. doi:10.1038/hr.2017.42

  19. Cupisti A, Giannese D, D'Alessandro C, et al. Kidney stone prevention: is there a role for complementary and alternative medicine? Nutrients. 2023;15(4):877. doi:10.3390/nu15040877

  20. Zhu W, Liu Y, Lan Y, et al. Dietary vinegar prevents kidney stone recurrence via epigenetic regulations. EBioMedicine. 2019;45:231–250. doi:10.1016/j.ebiom.2019.06.004

  21. Adelman A, Shilo Y, Modai J, et al. Do organic substances act as a degradable binding matrix in calcium oxalate kidney stones? BMC Urol. 2021;21:46. doi:10.1186/s12894-021-00818-3

  22. Launholt TL, Kristiansen CB, Hjorth P. Safety and side effects of apple vinegar intake and its effect on metabolic parameters and body weight: a systematic reviewEur J Nutr. 2020;59:2273–2289. doi:10.1007/s00394-020-02214-3

  23. Mission Pharmacal Company. Urocit-K (potassium citrate) extended-release tablets for oral use.

  24. NYU Langone Health. Medications & dietary changes for kidney stones.

By James Myhre & Dennis Sifris, MD
Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.