Table 2.

Lifestyle advice for urolithiasis patients; adapted from [1].

Stone type	Lifestyle advice/medication
Struvite	Antibiotics against urease producing bacteria Total stone removal To remove fragments transient acidification using l-methionine (200–500 mg, 3 times daily) to obtain a urine pH between 5.8 and 6.2 can be applied
	Drinking advice during the period of stone/fragment removal
Calcium oxalates/calcium phosphates Uric acid Ammonium urate	Drinking advice, to reach a urine volume of > 2 litre a fluid intake of > 2.5 litre is needed. For children the advice is > 1.5 l/m2 body surface area. Drinking should be distributed over the day with some concentration around food intake
	Extra fluid is needed to compensate sweat loss in a hot environment and during intensive physical activity
	Normal calcium intake, 1000–1200 mg/day except for patients with proven absorptive hypercalciuria (urine Ca > 8 mmol/day on average calcium intake and without ongoing bone loss)
	Limited NaCl intake, 4–5 g/day unless excessive sweat loss calls for extra NaCl intake
	Avoid excess animal protein (>1 g/kg/day). When a high animal protein intake does occur try to compensate this with extra fruit/vegetables
	Enough fruits and vegetables to maintain a neutral to slightly alkaline acid/base balance
	Try to obtain the recommended daily allowances for vitamins and minerals from the diet. Added vitamin/mineral can be applied but excess intake should be avoided
	Minimise intake of food items with a high oxalate content
	Strive for a BMI between 18 and 25 for adults. For children reduce overweight with respect to their age group. This advice is especially important for patients who form urate/uric acid containing stones