How to stop kidney stones coming back: water, salt and food in Nigerian heat

Why stones come back

A stone forms when urine is too concentrated and minerals in it crystallise. Once you have had one, you are more likely to have another. Hot weather, sweating at work, sitting in traffic without water, and long hours without a toilet all concentrate the urine. Many Nigerians drink little during the working day to avoid needing the toilet, and that habit matters.

Water: the one change that matters most

Aim to drink steadily through the day so your urine looks pale, like light lemon water, not dark yellow. Most adults who form stones need around two and a half to three litres a day, and more if you sweat a lot outdoors, work in the sun or exercise. Your doctor will give you a target if you have heart or kidney problems that limit fluids.

• Carry a bottle and refill it, rather than relying on buying sachet water when you remember
• Drink a glass with every meal and one before bed
• Drink more on hot days and when you travel, especially on long road trips
• Water is best; adding fresh lemon juice is a reasonable habit and some evidence suggests citrate helps

Salt and stock cubes

Salt makes the kidneys pass more calcium into the urine, which feeds the most common type of stone. Nigerian cooking often uses stock cubes and seasoning powders generously, and these are very salty. Use fewer cubes, taste before adding salt, and go easy on processed and salted foods such as instant noodle seasoning, salted fish, corned beef and snacks.

Food: what to limit and what not to cut

Do not stop milk, yoghurt, cheese or other calcium foods on your own. Normal amounts of dietary calcium bind oxalate in the gut and can lower your risk. Calcium supplements are different: ask your doctor before taking them.

• Eat moderate portions of meat, chicken, fish and offal rather than large amounts every day
• Limit very high-oxalate foods in large amounts if your stones were calcium oxalate: spinach, groundnuts and other nuts, chocolate, and very strong tea
• Cut down on sugary fizzy drinks, especially cola-type drinks
• Avoid high-dose vitamin C supplements unless prescribed
• Keep a healthy weight: obesity and diabetes increase stone risk

Get the stone and your urine tested

If you catch a stone, keep it and take it to your doctor. Stones are not all the same: calcium oxalate, uric acid and others each have their own advice. People who form stones repeatedly, or start young, may be offered a 24-hour urine test and blood tests to look for a cause such as gout, an overactive parathyroid gland or a urine infection.

Common questions