Kidney stones are tiny, hard deposits that form inside the kidneys, but the pain they cause can be severe.
A stone can sometimes pass without much trouble, but when it moves into the narrow tube between the kidney and bladder, it can cause intense pain in the side or back. Nausea, vomiting and blood in the urine can also occur.
The problem is common and often returns. In the United States, about one in 11 people will develop kidney stones during their lifetime, and many people who have had one will later develop another. Repeated stones can mean more pain, medical visits and time away from work or normal activities.
Doctors commonly advise people with a history of kidney stones to drink more water. More fluid usually produces more urine, which dilutes substances such as calcium and other minerals that can collect and form stones. Guidelines often recommend producing at least 2.5 liters of urine each day for people at risk of recurring stones.
But knowing that more water may help is very different from drinking enough every day for years. Work, travel, limited access to bathrooms, forgetfulness and personal habits can all make high fluid intake difficult. A major new study tested whether extra support could help people reach their hydration goals and prevent stones from returning.
The research was conducted by the Urinary Stone Disease Research Network and coordinated by the Duke Clinical Research Institute. The findings were published in The Lancet. Researchers enrolled 1,658 teenagers and adults at six major medical centers across the United States, making it an unusually large study of behavior-based kidney stone prevention.
Participants were randomly placed into two groups. One received usual care and general advice about drinking enough fluids. The other joined a structured hydration program designed to make drinking more water easier and more rewarding.
People in the special program received smart water bottles that recorded how much they drank. They were also given individual drinking goals, reminders, coaching and small financial rewards. Their daily fluid targets were calculated to help them produce at least 2.5 liters of urine a day.
Researchers followed the participants for two years. Importantly, they did not look only at whether people drank more water. They also used medical imaging and other information to determine whether new stones appeared or existing stones became larger.
The hydration program did change behavior. People who received the extra support drank more fluids and produced more urine than those receiving usual care. However, the difference was not enough to produce a significant reduction in kidney stone recurrence.
The results show one of the biggest challenges in preventing kidney stones: maintaining a large increase in daily fluid intake over a long period. Even smart bottles, reminders, coaching and rewards could not ensure that everyone consistently reached the recommended urine target.
The study does not mean that people at risk of kidney stones should stop drinking water. Good hydration remains an important part of prevention, and individual patients may still benefit from increasing their fluid intake. Instead, the findings suggest that simply telling people to drink more—or even giving them strong support to do so—may not be enough for everyone.
Researchers also say prevention may need to become more personal. Fluid needs can vary with body size, diet, physical activity, climate and other health factors. Future strategies could combine individualized hydration goals with dietary changes, medicines or other treatments that reduce the ability of minerals to form stones.
The study was strengthened by its large number of participants, two-year follow-up and focus on whether stones actually formed or grew. Still, changing a daily habit for years is difficult, and the research was conducted in the United States, so results may differ in other populations.
For people who repeatedly develop kidney stones, the message is more complicated than simply “drink more water.” Hydration remains useful, but long-term prevention may require a combination of practical support and treatments matched to each person’s individual risk.
Future research may help doctors find approaches that are easier to maintain and more effective at keeping painful stones from returning.
If you care about kidney health, please read studies about pesticide linked to chronic kidney disease, and this drug may prevent kidney failure in people with diabetes.
For more health information, please see recent studies about drug duo that may treat kidney failure, and results showing these vegetables may protect against kidney damage.
Copyright © 2026 Knowridge Science Report. All rights reserved.
