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A Smart Way to Prevent Kidney Stones

Urinary stone disease affects 1 out of 10 Americans, causing extreme discomfort and pain. Though most urinary stone treatments and research are focused on treating the patient’s pain, there is very little research about what can be done to prevent kidney stone development.

Surgeons from the Division of Urology at Washington University School of Medicine have joined forces with the Urinary Stone Disease Research Network (USDRN), a multidisciplinary team of experts around the country focused on designing and conducting clinical research studies in adults and children with urinary stone disease, to address and bridge this gap in kidney stone research.

Principal investigators Henry Lai, MD, Professor of Surgery and Alana Desai, MD, Assistant Professor of Surgery, collaborated with USDRN researchers to develop the Prevention of Urinary Stones with Hydration (PUSH) study. Designed as a randomized clinical trial, the PUSH study is working to determine whether behavioral interventions, including drinking more fluids, will prevent stone disease progression.

PUSH study participants receive a “smart” water bottle that synchronizes with a smartphone app. The smart bottle and app allow them to track their hydration throughout the day. Over a two-year period, participants are asked to drink enough to expel 2.5 liters of urine per day—about 10.5 cups.

“Although there are several factors associated with the development of kidney stones, one of the main risk factors is not drinking enough water,” Lai says. “It is our team’s hope to determine how kidney stone recurrence is affected by increased fluid consumption and urine output.”

As one of the leading recruitment sites, Washington University School of Medicine in St. Louis joined researchers from Duke University’s Clinical Research Institute, University of Washington, University of Texas Southwestern, University of Pennsylvania and Children’s Hospital in Philadelphia to plan, execute and analyze results of the study. The project was funded by a grant from the National Institutes of Health and National Institute of Diabetes and Digestive and Kidney Diseases.

“As urologists, it is our duty provide the best level of patient care,” Desai says. “By understanding what we can do to prevent kidney stones from recurring, it will give us greater insight to help lead our patients down a path toward recovery.”  

Lai and Desai’s PUSH team continues to recruit participants for this monumental research project. For eligibility details and to volunteer for the PUSH study, please contact Juanita Taylor at (314) 454-7047 or email the coordinators at