New Delhi: For years, people suffering from kidney stones have been advised to drink more water to prevent recurrence of this painful condition. But now a major study published in The Lancet shows that hydration alone may not be enough.The researchers found that despite regular reminders, counseling and encouragement to encourage more water intake, kidney stones continued to recur at the same rate.The study included 1,658 participants aged 12 and older who had a history of urinary stones and low urine output, a known risk factor for stone formation. One group received standard medical advice, while the other received a behavioral program designed to increase fluid intake through coaching, reminders, and personalized hydration goals.After two years of follow-up, symptomatic stone recurrence occurred in 19% of participants in the intervention group and 20% of participants in the standard-care group, showing no major difference.The researchers said that participants who received the intervention increased their urine output, meaning they were drinking more fluids. However, it did not significantly reduce the incidence of new stone formation, stone growth, or painful stones.Dr Manoj Kumar Singhal, director of nephrology and kidney transplant at Medanta Super Specialty, said the findings reflect what doctors have seen in clinical practice over the years.He added, “Hydration alone rarely tells the whole story. Kidney stone recurrence is fundamentally a metabolic disorder, not simply the result of low water intake.”According to Dr. Singhal, many patients who continue to develop stones despite drinking enough water may have underlying factors such as high salt intake, high animal protein consumption, abnormal calcium or uric acid levels in the urine, or a specific type of stone that requires targeted dietary correction.He said, “In many cases, a 24-hour urine analysis is far more informative than simply advising to drink more water. Patients with recurrent stones require a comprehensive metabolic assessment and individualized prevention strategy.”Experts said the findings do not mean hydration is unimportant, as low urine volume remains a major risk factor for kidney stones. Instead, studies suggest that fluid intake alone may not be enough for many patients and that factors such as diet, obesity, genetics, and metabolic disorders may also contribute significantly.The study also found that people who increased fluid intake reported greater urinary frequency, urgency, and nighttime urination during the early months of follow-up. No major safety concerns associated with increased hydration were reported.Kidney stones are becoming increasingly common around the world, including India, especially during extreme heat when the risk of dehydration increases rapidly. Doctors say adequate hydration is important, but patients with frequent kidney stones may need comprehensive prevention strategies, including dietary changes, medical evaluation and treatment of underlying risk factors.