How Much Water Should You Drink to Prevent Kidney Stones?

Not drinking enough overall, skipping fluids during busy parts of the day, avoiding fluids in the evening to cut nighttime bathroom trips, relying mostly on coffee, energy drinks or soda, not feeling thirsty (especially common in older adults), no routine or reminder, not liking the taste of water, fasting without planned hydration, eating mostly foods with little water in them, and fear of frequent urination (incontinence, work restrictions).

Eating a high-salt diet or a high-sugar diet (both mean less urine), and eating few fruits and veggies.

Dehydration from vomiting, diarrhea or sweating; fever or infection; kidney dysfunction or chronic kidney disease; heart failure; low blood pressure; severe burns or trauma; adrenal insufficiency (like Addison’s disease); obstruction from a large stone or an enlarged prostate; acute illness like flu or COVID; certain types of shock; and chronic bowel issues with excessive diarrhea.

Chronic use of NSAIDs like ibuprofen, ACE inhibitors or ARBs, diuretics used incorrectly, laxative abuse, chemotherapy drugs, anticholinergics, decongestants and overuse of antidiarrheals.

Hot, humid weather; intense exercise without rehydrating; heavy or hot clothing at work; saunas or steam rooms without replacing fluid; travel (long flights, avoiding airplane bathrooms); dieting without fluid awareness; drinking alcohol; high-protein or keto diets; religious fasting without water during the day; and living at high altitude.

• Start with a glass when you wake up, and drink 8 oz before breakfast.
• Drink a glass before coffee or tea, and keep a water glass by the coffee pot.
• Alternate water with each caffeinated drink and each alcoholic drink.
• Pair water with every meal and snack, and take a swig between bites.
• Pair a full glass of water with pills.
• Sip while you cook and prep food.
• Drink a glass every time you start a chore, during TV commercials, and after your shower.
• Take a sip every time you check your phone (this will help, since we are all addicted to our phones).
• Refill before bedtime, but only sip so you are not peeing ALL night.

• Bring water everywhere: the car, your bag, your desk, the gym, appointments, meetings and Zoom calls.
• Keep a bottle by the front door and extra bottles chilled for grab-and-go.
• Freeze half-full bottles for hot days.
• Sip at red lights, and grab water after every errand.
• Carry a bottle to social outings (and make sure you drink from it).

• Add cucumber, mint, watermelon, pineapple, berries, peaches, mango, basil or rosemary.
• Try combos: cucumber, mint and lime; strawberry and basil; peach and ginger; orange and rosemary.
• Apple slices with a cinnamon stick work warm on colder days.
• Keep a pitcher of infused “spa water” in the fridge.
• Make fruit or herb ice cubes, or use frozen grapes instead of ice.
• Mix sparkling water with a splash of 100% juice, or try flavored unsweetened seltzer and sparkling mineral water.
• Sip caffeine-free herbal teas, iced or hot. See my post on tea and kidney stones.
• Mix unsweetened coconut water into your water (I do this).
• Make mocktails with sparkling water and citrus, or popsicles with water and fruit (also me).
• Try room temperature if cold water bothers you (this is me).
• Treat water as dessert: ice cold, in a fancy glass (also me).

• Set hourly phone, calendar or smartwatch reminders.
• Use a water bottle with time markers or mark your own with goal times.
• Use a straw. You’ll sip more without noticing.
• Drink from a favorite mug, glass or bottle. I constantly switch mine to match my mood, and I love a simple mason jar!
• Fun-shaped ice cube trays are great for getting kids to drink.
• Leave “Drink now” notes around the house (you will often find a sticky note on Finn’s butt in my house).
• Share your progress with a friend, and celebrate small wins.

2.5 to 3 liters a day. For most people, that means drinking at least that much in fluids.

Yes. All fluids count. A regular cup of coffee, one or two a day, is fine; water is still best.

For flavor, yes. To prevent stones, only if a 24-hour urine collection shows you need citrate; otherwise lemon can raise your urine pH and your stone risk. My post on using lemons explains why.

Check the color of your urine every day: we want very pale yellow. To know for sure, measure it with a 24-hour urine collection.

Avoiding fluids in the evening is one of the common reasons for low urine volume. Refill before bedtime, but only sip so you are not up all night.

That’s ok and expected. Notice that you missed it, and get back on track the next day.

Normally, no would be my answer. Follow the Kidney Stone Diet^® goals to lower your risk and get a 24-hour urine collection done.