The #1 Stone Prevention Goal You Should Be Focused On

When starting the Kidney Stone Diet® goals, I am often asked which goal should be the priority. My response is always fluids. You must drink enough fluids to produce 2.5 – 3 liters of urine daily.

Below are common reasons people have low urine volume:

Fluid Intake Issues

1. Not drinking enough fluids overall
2. Skipping fluids during busy parts of the day
3. Avoiding fluids in the evening (to reduce nighttime bathroom trips)
4. Relying primarily on dehydrating drinks (coffee, energy drinks, soda)
5. Not feeling thirsty (especially common in older adults)
6. No routine or reminder to drink regularly
7. Aversion to the taste of water
8. Fasting without planned hydration
9. High reliance on solid foods with low water content
10. Fear of frequent urination (due to incontinence, work restrictions, etc.)
11. Eating a high salt diet (less urine produced)
12. Eating a high-sugar diet (less urine produced)
13. Eating a low-fruit and veggie diet

Physical & Medical Conditions

1. Dehydration (from vomiting, diarrhea, sweating)
2. Fever or infection
3. Kidney dysfunction or chronic kidney disease (CKD)
4. Heart failure (can lead to fluid retention, reducing urine)
5. Low blood pressure (hypotension)
6. Severe burns or trauma
7. Adrenal insufficiency (like Addison’s disease)
8. Obstructive uropathy (e.g., from a large stone or prostate enlargement)
9. Acute illness (like flu or COVID)
10. Certain types of shock (septic, hypovolemic)
11. Chronic bowel issues that lead to excessive diarrhea

Medications & Medical Interventions

1. Chronic use of NSAIDs (like ibuprofen—can reduce kidney blood flow)
2. ACE inhibitors or ARBs (can affect filtration in sensitive kidneys)
3. Diuretics used incorrectly (may dehydrate)
4. Laxative abuse (causes fluid loss)
5. Chemotherapy drugs (can damage kidney function)
6. Anticholinergics (can cause urinary retention)
7. Decongestants (can raise blood pressure and affect kidney function)
8. Overuse of antidiarrheals

Environmental or Lifestyle Factors

1. Hot, humid weather (causes sweating and fluid loss)
2. Intense exercise without proper rehydration
3. Wearing heavy or hot clothing (e.g., specific jobs or uniforms)
4. Sauna or steam room use without fluid replacement
5. Traveling (long flights, avoiding airplane bathrooms)
6. Dieting without fluid awareness
7. Drinking alcohol (diuretic leads to net fluid loss)
8. High-protein or keto diets (require more water for excretion)
9. Religious fasting (e.g., Ramadan, without water during the day)
10. Living at high altitudes (can lead to insensible fluid loss)

You might think: “So, lady, how do I meet my fluid goals daily?”

Here are some tips I have discussed with students and patients over the years; hopefully, you can find some that work for you!

Morning & Mealtime Habits 

1. Start with a glass when you wake up
2. Drink 8 oz before breakfast
3. Keep a water glass by the coffee pot
4. Take a swig between bites at meals
5. Make it a lunch break habit
6. Before your afternoon snack, drink first
7. Pair a full glass of water with pills
8. Finish meals with sparkling water
9. Use a straw—it increases sipping
10. Always have water withtea/coffee
11. Make hydration part of your “reset” after lunch
12. Sip while prepping food
13. Add mint, berries, and or cucumber during breakfast
14. Use colorful cups to make it fun
15. Set a timer to drink every 15 minutes
16. Have water when reading or journaling
17. Make your dinner water fancy with mint
18. Fill a big jug at the start of dinner
19. Drink a glass after meals to signal digestion
20. Pour a fresh nighttime glass before bedtime

B. On-the-Go Hacks 

1. Always carry a reusable water bottle
2. Pick breeds you love—BPA-free wide mouths are great
3. Keep one bottle in the car
4. Pass a bottle when getting out at gas stations
5. Sip at red lights
6. Freeze half-full bottles for hot days
7. Refill at public water fountains after errands
8. Pack one in your gym bag
9. Bring to appointments (salons, waiting rooms, etc.)
10. Attach it to your purse or backpack
11. Use different colored lids to track intake
12. Grab water after every errand
13. Juice bars can add flavor without sugar
14. Take a sip every time you check your phone (this will help since we are all addicted to our phones)
15. Keep one bottle at your desk
16. Bring to meetings and Zoom calls
17. Keep a bottle by the front door
18. Refill on-route during walks

C. Flavor & Variety 

1. Infuse with fruit slices
2. Use fresh herbs (mint, basil, rosemary)
3. Add berries or melon cubes (I love these)
4. Try cucumber + lime
5. Make iced herbal teas
6. Swap in green/white tea (cup or two per day)
7. Mix sparkling with flat water
8. Use unsweetened coconut water (I mix this with my water)
9. Try mineral water for fizz
10. Add a splash of 100% unsweetened fruit juice

D. Reminders & Monitoring 

1. Set hourly phone reminders
2. Use an app to track intake (check the app store on your phone to see which one you like)
3. Chart daily goals with stickers
4. Set morning/afternoon hydration alarms
5. Use voice reminders (e.g., “Time for water!”)
6. Track the color of urine daily (we want very pale yellow)
7. Leave notes (“Drink now”) around your home (you will often find a sticky memo on Finn’s butt in my house)
8. Set hourly calendar blocks
9. Use a smart bottle to track sips
10. Log intake in a wellness journal
11. Reward milestones (glass 10 = 10 squats)
12. Share progress with a friend
13. Mark bottles with goal times
14. Use smartwatch hydration reminders

E. Daily Routines 

1. Pair with bathroom routine
2. Hydrate before and after meals
3. Take sips during breaks
4. Water before/after exercise
5. Refill before bedtime (but only sip so you are not peeing ALL night)
6. Drink post-shower
7. Hydrate after laundry breaks
8. Drink during TV commercials
9. Keep water by the toilet
10. Sip during cooking
11. Carry to social outings (but also make sure you drink from it)
12. Hydrate before bedtime reading
13. Drink a glass every time you start a chore
14. Always refill immediately
15. Reflection sip before sleeping

F. Tech & Tools 

1. Buy a smart reminder bottle
2. Use hydration-tracking apps
3. Get a bottle with time markers
4. Use voice assistant reminders
5. Use a bottle with a straw
6. Use straw caps for sipping ease
7. Choose leak-proof bottles for travel
8. Choose insulated bottles to maintain temp

Some of these tips will work for you, some will not. The trick is finding one that works for you. My diet teachings are based upon this mantra; “Because it works for him doesn’t mean it will work for you.” Don’t give up until you find the tip that works for you, no matter what you try to change.

And don’t worry if you have a day where you didn’t make your goal. We all have those days. Just get back on track the next day!

Drinking enough water to produce 2.5-3 liters per day of urine is how we begin to prevent kidney stones. The more we pee, the less likely we are to make stones. The End!

Cheers!

Your friend,
Nurse Jill