1. Drink More Water! Nothing else in this list is more important. No matter what kind of stone you have, there was not enough water available to the kidneys to dissolve all the minerals and waste products your body was producing at the time the stone was formed. If there had been more water available at that time you wouldn't have made the stone! Lemonade is almost as good as water because it contains citrate which helps prevent stone formation.

2. Strain All The Urine And Find The Stone. The chemical composition of the stone is critical in determining the optimal preventive therapy. Without this information, it will be more difficult for your physician to give you good advice on stone prevention. Sometimes it's just not possible to retrieve the stone, but it's important to make every effort to try and find it. Strain all the urine every time you void until your physician tells you to stop. The most common reason stones are passed without being collected is the failure to strain the urine every single time you urinate.

3. Collect And Analyze The Stone Even If You've Done It Before. All stones must be analyzed because the stone composition and the problems causing the stones can change over time.

4. Avoid Urinary Tract Infections. These are most common in women. An infection not only changes the types of stones that can be produced, but it creates the potential for a very serious kidney infection that may require surgery. Much better to avoid getting any infections. To do this, drink plenty of water, wash your hands often, use showers, avoid baths, wipe the area around the bladder area correctly and wash it with a separate, clean washcloth using liquid soap.

5. Eliminate Dietary Excesses. It's rarely necessary to totally eliminate any particular food, but many patients will need to cut back on any obvious excesses like 16 oz. steaks.

6. Find A Good Physician. Not every physician is interested or knowledgeable about kidney stone prevention. If you've found one, great! If not, ask your regular physician if he can recommend someone or call the National Kidney Stone Network Database at 916.781.3440 where they keep track of physicians who have an interest in this area.

7. Get A Metabolic Stone Prevention Study. If you are truly serious about preventing more stones, it's necessary to know exactly which chemical risk factors are abnormal and require treatment. The only way to know is to have the necessary blood and 24 hour urine chemistry tests performed and evaluated properly. Then follow your physician's advice.

8. Try Dietary Measures First If Possible. On a long term basis, you will be better off not relying too much on prescription medicines if dietary adjustments alone are effective. Medications often have side effects over long periods of time, so it is best to avoid them if possible. Follow the recommended diets. These will usually include low salt, less red meat protein and low oxalates. Salt, meat and high oxalate foods like chocolate, nuts and spinach will all increase the risk of new kidney stone formation. Try to limit the amount of these products that you eat at any one time. If you eat more than you should, drink at least two extra glasses of water to help rinse any crystals out and dilute the urine you will be making to reduce the chance of forming more stones.

9. Don't Lower Your Calcium Intake Too Much. We now know that it's dangerous to lower your calcium intake too much because it can actually increase calcium stone production. Moderation is recommended at about 600-800 mg of calcium per day. This is equivalent to about one good calcium meal per day.

10. Follow Your Doctor's Advice. If you need to take medication or supplements regularly as prescribed by your physician, please do so. Physicians don't recommend these treatments, especially on a long term basis, unless they feel strongly that the therapy will provide you with a substantial benefit.

11. Get Rechecked Regularly. Your body chemistry can change over time and when you modify one chemical element in your diet you may inadvertently increase another and create a new stone formation risk factor. In general, we recommend a metabolic retest two to three months after starting any new treatment until all risk factors have been corrected. Then just once a year. We also recommend having an X-ray check of the kidneys every year or two to make sure no new stones are produced.

12. Get Good Kidney Stone Prevention Advice, News And Updates. Subscribe to the Kidney Stone Network Newsletter and order a copy of The Kidney Stones Handbook from Four Geez Press. You can call them at 1-800-2KIDNEYS (800-254-3639).