Several studies suggest that chronic dehydration from different causes such as working in a hot environment or physical exertion increases the risk of stone incidence.1-5 Data suggests also that stone diseases occur more frequently in geographic areas with a hot climate. In countries such as Saudi Arabia, over 20% of the population develop renal stones whereas the risk of the disease is only 12 to 13% in North America and 5 to 10 % in Europe.6 There is also a seasonal variation of stone incidence, with higher rates in summer.7,8
In addition, some studies show the relationship between fluid intake and stone risk in the healthy population:
- In two large observational studies, total fluid intake was significantly and negatively associated with the risk of renal stones.9,10
- A three-year intervention controlled trial tested the preventive effect of an educational program on adequate fluid intake in a population living in a hot climate compared to a similar population who did not receive any advice. Results showed that the population with the educational program had a higher urine volume and a lower stone incidence than the population who were not advised on fluid intake.11
It has also recently been shown that an additional water intake of 1.3 L could decrease the theoretical risk of crystallization, the first step of stone formation, in the urine of a healthy population as measured by the Tiselius crystallization risk index.12
Nevertheless, further studies are needed to confirm the role of adequate fluid intake for first stone prevention.
- Embon OM, Rose GA, Rosenbaum T. Chronic dehydration stone disease. Br J Urol. 1990;66:357-62.
- Pin NT, Ling NY, Siang LH. Dehydration from outdoor work and urinary stones in a tropical environment. Occup Med (Lond). 1992;42:30-2.
- Borghi L, Meschi T, Amato F, Novarini A, Romanelli A, Cigala F. Hot occupation and nephrolithiasis. J Urol. 1993;150:1757-60.
- Chang MA, Goldfarb DS. Occupational risk for nephrolithiasis and bladder dysfunction in a chauffeur. Urol Res. 2004;32:41-3.
- Olapade-Olaopa EO, Agunloye A, Ogunlana DI, Owoaje ET, Marinho T. Chronic dehydration and symptomatic upper urinary tract stones in young adults in Ibadan, Nigeria. West Afr J Med. 2004;23:146-50.
- Ferrari P, Piazza R, Ghidini N, Bisi M, Galizia G, Ferrari G. Lithiasis and risk factors. UrolInt. 2007;79:8-15.
- Baker PW, Coyle P, Bais R, Rofe AM. Influence of season, age, and sex on renal stone formation in South Australia. Med J Aust. 1993;159:390-2.
- Al-Hadramy MS. Seasonal variations of urinary stone colic in Arabia. J Pak Med Assoc. 1997;47:281-4.
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J AmSocNephrol. 2004;15:3225-32.
- Curhan GC, Willett WC, Knight EL, Stampfer MJ. Dietary factors and the risk of incident kidney stones in younger women: Nurses' Health Study II. ArchInternMed. 2004;164:885-91.
- Frank M, De Vries A. Prevention of urolithiasis. Education to adequate fluid intake in a new town situated in the Judean Desert Mountains. ArchEnvironHealth. 1966;13:625-30.
- De La Guéronnière V, Le Bellego L., Buendia Jimenez I, Dohein O, Tack I, Daudon M. Increasing water intake by 2 liters reduces crystallization risk indexes in healthy subjects. ArchItalUrolAndrol. 2011;83:43-50.