Kidney Stone (Urolithiasis) Prevention Diet: Fluid, Citrate, Oxalate & Sodium Guidelines

Medical Nutrition Therapy (MNT) reduces 5-year kidney stone recurrence by more than 50%. Contrary to popular myth, restricting dietary calcium actually increases calcium oxalate stone risk; instead, normal dietary calcium (1,000–1,200 mg/day consumed with meals) binds dietary oxalate in the intestinal lumen and prevents enteric hyperoxaluria.

4 Pillars of Renal Stone Prevention

1. Target Urine Volume ≥ 2.5 Liters/Day: Consuming 3.0+ liters of water daily dilutes urinary supersaturation of calcium oxalate, calcium phosphate, and monosodium urate.
2. Natural Urinary Citrate Alkalinization: Fresh lemon and lime juice increase urinary citrate excretion; citrate complexes with ionized urinary calcium and raises urine pH to prevent uric acid crystallization.
3. Sodium Restriction (< 2,300 mg/day): High sodium intake increases proximal tubular sodium rejection, which obligates parallel urinary calcium excretion (hypercalciuria).
4. Moderate Animal Purines & High-Oxalate Foods: Limit spinach, rhubarb, beet greens, concentrated nuts, and excess red meat/organ purines.