Getting Creative About Reducing Kidney Stones

In order to solve the uptick in kidney stone rates, researchers look to technology and incentives to get participants to drink more water.


A “smart” water bottle—or money—or a coach? What’s the best way to encourage people at risk for kidney stones to drink more water? The prevalence of urinary stones has nearly doubled in the past 15 years, affecting 1 in 11 people, according to the National Institute of Health (NIH). The NIH says little high-quality research exists related to how to prevent stones, and most therapies treat people with the condition only after they are in excruciating pain.

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To test new solutions, researchers from the Urinary Stone Disease Research Network and Duke Clinical Research are recruiting 1,642 participants for Prevention of Urinary Stones with Hydration (PUSH), a 2-year multisite clinical trial funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

People with kidney stones, when counseled to drink more water, usually only increase intake by small amounts. So participants in the intervention group will receive water bottles (Hidrate Spark) that connect to an app and monitor how much they drink, with a goal of 2.5 liters of water per day. They will also receive financial incentives if they achieve their fluid targets, and meet with a health coach who will help them identify barriers to drinking more liquids and help devise solutions.

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“Urinary stones are painful and debilitating, and their treatment is expensive,” said Ziya Kirkali, MD, program director of urology clinical research and epidemiology in NIDDK’s Division of Kidney, Urologic, and Hematologic Diseases. “If successful, the study could change management of kidney stones.”

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