Fluid Intake Application to Reduce Kidney Stone Risks

The prevalence of kidney stone disease in the United States is increasing. Recurrence of kidney stone disease has been reported as high as 50% at five years. Urine supersaturation is a predominant factor in the formation of crystallization and stone disease and is dependent on fluid volume. High fluid consumption that dilutes the urine has been shown both in vitro and in clinical studies to reduce the tendency for stone crystallization as well as effectively decrease stone recurrence. As a result, water intake greater than two liters per day is a common initial therapy for prevention of stone disease. However, studies have shown that despite physician counseling most patients are only able to modestly increase their urine volume through fluid intake. This finding may be due to a discrepancy in patient perception of their actual fluid intake and resulting urine volume. The purpose of this investigation is to prospectively evaluate the benefit of different methods of educating patient regarding their fluid intake through a readily available daily cellular phone application to improve overall urine output and reduce risk factors for stone recurrence.

Inclusion criteria

• Patients ≥ 18 years old
• Seen in urology or nephrology clinic at UNC with a diagnosis of kidney stone
• Prior 24-hour urine result with volume less than 2 to 2.5 liters

Exclusion criteria

• Patient without cellular phone capable of utilizing Android / Apple application
• Patient already using some form of monitoring fluid intake / volume
• Inability to take fluid by mouth
• Patient with urinary diversion, chronic diarrhea, bowel diversion or other forms of excessive fluid loss
• Inability to obtain informed consent
• Non-English speaking