Anyone who has passed a kidney stone tends to remember it. The pain can be severe enough to send people to the emergency room, and the first question afterward is usually how to avoid another one. The answer depends partly on the kind of stone, and partly on habits that are easy to underestimate, including how much you sweat in the Florida heat.

How common stones are, and why they return

The National Kidney Foundation estimates that about 1 in 10 people will have a kidney stone at some point. Once you have had one, the chance of another is high: NKF puts it at about 1 in 2 or more.

Stones form when minerals in the urine, such as calcium, oxalate and phosphorus, become concentrated enough to crystallize. NIDDK notes these minerals are normally present in urine and cause no trouble at low levels. There are four main types: calcium stones (calcium oxalate is the most common), uric acid, struvite and cystine.

Mayo Clinic lists the main risk factors: a personal or family history of stones, not drinking enough water, diets high in sodium, protein, oxalate and sugar, obesity, digestive diseases or gastric bypass surgery, and some supplements and medicines, including vitamin C supplements, calcium-based antacids and laxative overuse.

Why heat matters here

Mayo Clinic notes that people who live in warm climates and those who sweat a lot may be at higher risk, because sweat loss leaves less water to dilute the urine. The research supports this. A 2014 study of more than 60,000 patients in five US cities found that kidney stone visits generally rose with hotter days, with the strongest effect within about three days of the heat.

The southeastern United States has long been described as a kidney stone “belt.” A 2008 climate modeling study projected that warming would widen that zone, with Florida among the states where increases would be concentrated.

For people here, that means fluid needs change with the weather and the activity. A round of golf, an afternoon on the boat or yard work in August all raise the amount you need to drink. Our article on heat, hydration and your kidneys covers hot-weather habits in more detail.

Prevention that works

The American Urological Association published an updated medical management guideline in 2026, covering evaluation, diet and medicines for people who have had stones. The core advice from national sources is consistent:

  • Drink enough to make plenty of urine. For people prone to calcium stones, the National Kidney Foundation cites a common target of enough fluid to make about 2.5 liters (85 ounces) of urine a day. In hot weather that takes more fluid than most people expect.
  • Do not cut out calcium. It sounds backward, but NIDDK explains that calcium from food, in the right amounts, binds oxalate in the gut before it reaches the kidneys.
  • Lower sodium. NIDDK advises under 2,300 mg of sodium a day. Mayo Clinic explains that extra sodium raises the amount of calcium the kidneys must filter.
  • Limit animal protein such as beef, pork, chicken, fish and shellfish, and replace some with beans, lentils and other plant proteins.
  • For calcium oxalate stones, NIDDK suggests limiting high-oxalate foods such as spinach, rhubarb, nuts and wheat bran.
  • For uric acid stones, NIDDK notes that losing weight, if you are overweight, is especially important.

Fluid limits are the exception. If your doctor has told you to restrict fluids, for example because of heart failure or advanced kidney disease, ask how much to drink rather than following a general target.

Finding out why your stones form

Prevention works best when it is aimed at the cause. If you pass a stone, NIDDK says your clinician may ask you to catch it so a lab can analyze its type. The National Kidney Foundation recommends that people who have had more than one stone do a 24-hour urine collection at least once a year, which measures urine volume and the minerals that drive stone formation.

Depending on the results, a doctor may add medicine. NIDDK lists potassium citrate and certain diuretics for calcium stones, allopurinol for uric acid stones, and specific treatments for struvite and cystine stones. Stones can also be a sign of another condition. The National Kidney Foundation links them to diabetes, gout, inflammatory bowel disease and an overactive parathyroid gland, among others, which is one reason recurrent stones deserve a full look.

When to get help right away

Mayo Clinic advises getting checked right away for pain so bad you cannot sit still or find a comfortable position, pain with nausea and vomiting, pain with fever and chills, blood in the urine, or trouble passing urine. NIDDK adds that stones that block the urinary tract or cause great pain may need urgent treatment, and that vomiting with dehydration may call for hospital care and IV fluids. If you cannot reach your doctor quickly, go to an emergency room or call 911.

Dr. Yana Shtern is board-certified in Internal Medicine and Nephrology, and recurrent stones sit squarely within kidney care. Labs are drawn in our office, and members can reach the practice by phone at any hour. You can read more on our kidney care page. If stones have become a pattern for you, a complimentary meet and greet with Dr. Shtern is a sensible first step.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.