Fluid Intake Application to Reduce Kidney Stone Risks

The prevalence of kidney stone disease in the United States is increasing. Recurrence of
kidney stone disease has been reported as high as 50% at five years. Urine supersaturation
is a predominant factor in the formation of crystallization and stone disease and is
dependent on fluid volume. High fluid consumption that dilutes the urine has been shown both
in vitro and in clinical studies to reduce the tendency for stone crystallization as well as
effectively decrease stone recurrence. As a result, water intake greater than two liters per
day is a common initial therapy for prevention of stone disease. However, studies have shown
that despite physician counseling most patients are only able to modestly increase their
urine volume through fluid intake. This finding may be due to a discrepancy in patient
perception of their actual fluid intake and resulting urine volume. The purpose of this
investigation is to prospectively evaluate the benefit of different methods of educating
patient regarding their fluid intake through a readily available daily cellular phone
application to improve overall urine output and reduce risk factors for stone recurrence.

Inclusion Criteria:

1. Patients ≥ 18 years old

2. Seen in urology or nephrology clinic at UNC with a diagnosis of kidney stone

3. Prior 24-hour urine result with volume less than 2 to 2.5 liters

Exclusion Criteria:

1. Patient without cellular phone capable of utilizing Android / Apple application

2. Patient already using some form of monitoring fluid intake / volume

3. Inability to take fluid by mouth

4. Patient with urinary diversion, chronic diarrhea, bowel diversion or other forms of
excessive fluid loss

5. Inability to obtain informed consent

6. Non-English speaking