By Dr. Simon Prince, FACP, FASN

Dr. Simon Prince is a founder of North Shore Nephrology, P.C. in Manhasset and a Clinical Assistant Professor of Medicine at NYU School of Medicine. He can be contacted at 516-365-5570, www.nsneph.com and www.uremicfrost.com.

It was a typical day for John, a 33-year-old firefighter. He is strong, healthy and physically active. When John experienced sudden pain in his right lower back region, he thought he just pulled a muscle and completely ignored it.

However, the pain continued throughout the evening. As time passed, it was becoming more intense and eventually radiated to his groin. Not knowing how to handle the situation, John decided to take Tylenol without even mentioning it to his wife, and tried to go to sleep. An hour later John was in the emergency room with excruciating, unbearable pain. There was an intravenous line attached to his hand, and he was receiving fluids and narcotic pain medications to treat his kidney stone.

This is not an uncommon scenario and nearly everyone has predisposition towards this disorder. What people should keep in mind is that kidney stones can develop surprisingly easily and have a very high prevalence in our society. Nearly 10 percent of adults will develop at least one stone by the age of 70. As summer approaches and the temperature rises, so does the risk for kidney stone disease.

So, how could John have avoided the emergency room, along with the pain and suffering that come with a kidney stone?

When it comes to kidney stone prevention, there are three most important things people should do, regardless of their age: stay well hydrated, stay well hydrated and stay well hydrated.

The best and most effective way to prevent kidney stones is to minimize the risk factors. There are several risk factors every individual should be aware of. The most essential one is low fluid intake which leads to low urinary volume. Other causes include a personal or family history of kidney stones, certain dietary factors, chronic urinary tract infections and some other specific medical conditions.

So, you are probably wondering how much fluid you should drink? Was your mother right about eight cups of water a day? The answer is two-fold. It depends on the size of the cup, as well as your individual hydration status and needs. The general goal for people who are at risk for stone formation is to drink enough fluid to produce at least two liters of urine a day. This may require drinking at least 2 to 2.5 L daily.

A good rule of thumb is to drink until your urine appears clear. If it is too dark, you might need to increase your fluid intake. Water is usually your best bet. But according to some studies, lemonade and certain diet sodas (Sunkist Diet Orange and Diet 7 Up) may have additional benefits. Alcoholic and caffeinated beverages, as well as colas are to be discouraged.

Once a patient has passed a stone, there is a strong possibility that another stone will be passed in his or her lifetime. Since kidney stones may be hereditary, the risk factors can be passed on to the next generation. Preventive measures should be life-long, especially after the first stone episode. Careful risk assessment and monitoring with your physician is highly-recommended. Needless to say, you don’t want to end up in the emergency room like John.