{"id":10194,"date":"2026-05-13T20:00:00","date_gmt":"2026-05-13T13:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=10194"},"modified":"2026-08-16T22:23:39","modified_gmt":"2026-08-16T15:23:39","slug":"%e0%a6%95%e0%a6%bf%e0%a6%a1%e0%a6%a8%e0%a6%bf-%e0%a6%aa%e0%a6%be%e0%a6%a5%e0%a6%b0%e0%a6%bf-%e0%a6%aa%e0%a7%8d%e0%a6%b0%e0%a6%a4%e0%a6%bf%e0%a6%b0%e0%a7%8b%e0%a6%a7-%e0%a6%8f%e0%a6%ac%e0%a6%82","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/bn\/2026\/05\/13\/kidney-stone-prevention-management-guide\/","title":{"rendered":"\u0995\u09bf\u09a1\u09a8\u09bf \u09b8\u09cd\u099f\u09cb\u09a8 \u09aa\u09cd\u09b0\u09a4\u09bf\u09b0\u09cb\u09a7 \u098f\u09ac\u0982 \u09ac\u09cd\u09af\u09ac\u09b8\u09cd\u09a5\u09be\u09aa\u09a8\u09be: \u09aa\u09be\u09a5\u09b0-\u09ae\u09c1\u0995\u09cd\u09a4 \u09a5\u09be\u0995\u09be\u09b0 \u098f\u0995\u099f\u09bf \u0986\u09a7\u09c1\u09a8\u09bf\u0995 \u0997\u09be\u0987\u09a1"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-e269d6e6 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=800%2C800&#038;ssl=1\" alt=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" class=\"wp-image-7037\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=12%2C12&amp;ssl=1 12w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=600%2C600&amp;ssl=1 600w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?resize=400%2C400&amp;ssl=1 400w, 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 title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Kidney stones are one of the most common urological conditions I see \u2014 and one of the most preventable. Here is a patient-friendly overview of <strong>how stones form, how diet genuinely changes the odds, and where treatment such as ESWL fits in<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This article draws on a presentation I gave at the <strong>Royal Phnom Penh Urology Seminar in June 2019<\/strong>. Several years on, the principles of stone prevention have not changed much, which is itself a useful signal about which advice is worth following.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"600\" data-attachment-id=\"10244\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/kidney-stone-prevention-6-keys-to-staying-stone-free\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-6-Keys-to-Staying-Stone-Free.jpg?fit=800%2C600&amp;ssl=1\" data-orig-size=\"800,600\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Kidney Stone Prevention \u2014 6 Keys to Staying Stone-Free | Visual Summary by Dr. Soarawee\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Kidney Stone Prevention \u2014 6 keys to staying stone-free&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-6-Keys-to-Staying-Stone-Free.jpg?fit=800%2C600&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-6-Keys-to-Staying-Stone-Free.jpg?resize=800%2C600&#038;ssl=1\" alt=\"Infographic by Dr. Soarawee Weerasopone \u2014 six keys to staying stone-free, covering hydration, calcium, oxalate, sodium, protein and citrate intake for kidney stone prevention\" class=\"wp-image-10244\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-6-Keys-to-Staying-Stone-Free.jpg?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-6-Keys-to-Staying-Stone-Free.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-6-Keys-to-Staying-Stone-Free.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-6-Keys-to-Staying-Stone-Free.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Kidney stone prevention \u2014 six keys to staying stone-free.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">First: When a Stone Is an Emergency<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Prevention is slow work. This part is not. <strong>Go to an emergency department rather than waiting for an appointment if you have:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fever or shaking chills together with flank pain<\/strong> \u2014 a blocked kidney that is also infected can progress to sepsis within hours and needs drainage, not antibiotics alone. This is the one that kills people.<\/li>\n\n\n\n<li>Pain that ordinary painkillers are not touching, or persistent vomiting.<\/li>\n\n\n\n<li><strong>Passing little or no urine<\/strong>, especially with a single kidney or stones on both sides.<\/li>\n\n\n\n<li>Flank pain during pregnancy, or with known kidney impairment or a transplanted kidney.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">The Balance of Salts<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Kidney stones are fundamentally about a <strong>disruption in the balance of salts within the urinary tract<\/strong>. Picture a salt farm: sea water is let in, the water evaporates, and salt is left behind. Stones form when urine becomes supersaturated with poorly soluble compounds that can no longer stay dissolved, and crystals precipitate.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Who Is at Risk?<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Sex and age:<\/strong> more common in men, and typically first appearing in young to middle adulthood.<\/li>\n\n\n\n<li><strong>Lifetime prevalence:<\/strong> roughly one in eight men and one in fourteen women will have a stone at some point.<\/li>\n\n\n\n<li><strong>Other conditions:<\/strong> obesity, high blood pressure and diabetes all raise the risk.<\/li>\n\n\n\n<li><strong>Family history:<\/strong> a close relative with stones meaningfully increases your own risk.<\/li>\n\n\n\n<li><strong>Climate and occupation:<\/strong> heat and sweating matter a great deal in Thailand, and outdoor work is its own risk factor.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Why Do Stones Form?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Supersaturation arises mainly from <strong>dehydration and inherited tendencies<\/strong> to excrete more of certain ions. The building blocks include calcium, oxalate, phosphate, magnesium and uric acid. The four common types are <strong>calcium oxalate<\/strong> (by far the most frequent), <strong>struvite<\/strong> (associated with infection), <strong>uric acid<\/strong> (linked to persistently acidic urine) and <strong>calcium phosphate<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which one you make changes the advice completely \u2014 uric acid stones can often be dissolved with medication, as described in <a href=\"https:\/\/drsoaraweeurology.com\/2026\/06\/03\/uric-acid-kidney-stones-case-study\/\">this case study<\/a>, while calcium stones cannot. <strong>That is why any stone you pass should be kept and sent for analysis.<\/strong> A fragment in a clean container is worth more than a description of it.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"418\" height=\"314\" data-attachment-id=\"9950\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/june-2019-with-arjan-damrongpan-4\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-4.webp?fit=418%2C314&amp;ssl=1\" data-orig-size=\"418,314\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Dr. Pom and Dr. Damrongpan Watanachote at Royal Phnom Penh, June 2019\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Pom alongside Dr. Damrongpan Watanachote at Royal Phnom Penh urology seminar, June 2019&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-4.webp?fit=418%2C314&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-4.webp?resize=418%2C314&#038;ssl=1\" alt=\"Dr. Soarawee Weerasopone with Dr. Damrongpan Watanachote at the Royal Phnom Penh urology seminar, June 2019\" class=\"wp-image-9950\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-4.webp?w=418&amp;ssl=1 418w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-4.webp?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-4.webp?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 418px) 100vw, 418px\" \/><figcaption class=\"wp-element-caption\">With Dr. Damrongpan Watanachote at the Royal Phnom Penh urology seminar, June 2019.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The Pillar of Prevention: Dietary Control<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The magic words are <strong>balance, balance and balance<\/strong>. The figures below are general targets used for stone formers; the precise plan for any individual comes after stone analysis and, where indicated, a metabolic evaluation. They are a starting point for a conversation, not a prescription to self-apply.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Fluid Intake \u2014 The Most Important Factor<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Dehydration is the most important and easiest factor to correct. The usual recommendation is <strong><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10201681\/\" target=\"_blank\" rel=\"noreferrer noopener\">more than 2.5 litres of fluid daily<\/a><\/strong>, adjusted upward in heat or with heavy sweating. The practical marker is pale urine throughout the day. <strong>One exception worth stating:<\/strong> if you have heart failure, significant kidney impairment or have been told to restrict fluids, agree your target with your doctor rather than following a general number.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10200\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/water-intake\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Daily Water Intake for Kidney Stone Prevention \u2014 More Than 2.5 Liters per Day\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Glasses of water illustrating the recommended daily fluid intake of more than 2.5 litres for kidney stone prevention\" class=\"wp-image-10200\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Water-intake.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Fluid intake is the single most effective dietary step \u2014 aim for urine that stays pale.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Calcium \u2014 The Common Misconception<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Many patients believe they should cut out calcium to prevent calcium stones. <strong>This is backwards.<\/strong> Low dietary calcium leaves more oxalate free to be absorbed and excreted, and it raises stone risk rather than lowering it.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The target:<\/strong> <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa010369\" target=\"_blank\" rel=\"noreferrer noopener\">800 to 1,200 mg a day<\/a>, from food where possible.<\/li>\n\n\n\n<li><strong>Why:<\/strong> in a randomised trial in men with recurrent calcium oxalate stones, a normal-calcium diet with reduced animal protein and salt roughly halved recurrence compared with a low-calcium diet.<\/li>\n\n\n\n<li><strong>Practical point:<\/strong> if you take calcium supplements, take them <em>with meals<\/em>, so the calcium binds oxalate in the gut instead of being absorbed. Supplements taken between meals do not have the same protective effect.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10197\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/calcium-intake\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Recommended Calcium Intake for Kidney Stone Prevention \u2014 800 to 1,200 mg per Day\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Calcium-rich foods including milk, cheese, yoghurt and leafy greens \u2014 a normal dietary calcium intake of 800 to 1,200 mg a day helps prevent calcium oxalate kidney stones\" class=\"wp-image-10197\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Calcium-intake.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Normal dietary calcium, taken with meals, helps prevent calcium oxalate stones rather than causing them.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Oxalate Management<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Because calcium oxalate is the most common stone type, oxalate matters \u2014 but the aim is <strong>moderation rather than elimination<\/strong>. Very restrictive oxalate diets are hard to sustain and cut out genuinely healthy foods. The higher-oxalate items worth moderating include spinach, rhubarb, beetroot, nuts, seeds, dark chocolate and cocoa, black tea and some soy products.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The most useful single habit is not avoidance but pairing: <strong>eat oxalate-containing foods together with a calcium-containing food in the same meal<\/strong>, so the two bind in the gut rather than in your kidney.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10198\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/oxalate-intake\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"High-Oxalate Foods to Limit for Kidney Stone Prevention \u2014 40 to 50 mg Daily\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?resize=800%2C533&#038;ssl=1\" alt=\"High-oxalate foods including spinach, dark chocolate, nuts, beetroot and rhubarb, which are moderated rather than eliminated in calcium oxalate stone prevention\" class=\"wp-image-10198\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Oxalate-intake.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Higher-oxalate foods are moderated rather than banned \u2014 and best eaten alongside a calcium-containing food.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Sodium and Protein<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Sodium:<\/strong> a high salt intake pushes more calcium into the urine. Aiming for 2,000 to 3,000 mg of sodium a day helps, and in Thai cooking most of it comes from sauces and seasoning rather than the salt shaker.<\/li>\n\n\n\n<li><strong>Protein:<\/strong> very high intakes acidify the urine and raise urinary calcium. A moderate intake of roughly 0.8 to 1.4 g per kg per day is the usual target. Evidence does not show a clear difference in stone risk between animal and plant protein at moderate intakes.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Vitamin C<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Vitamin C in food is not a problem. High-dose <em>supplements<\/em> are, because excess ascorbate is metabolised to oxalate: intakes above 1,000 mg a day have been associated with a <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4769668\/\" target=\"_blank\" rel=\"noreferrer noopener\">meaningfully higher risk of stones<\/a>. If you form calcium oxalate stones, high-dose vitamin C is one supplement worth stopping.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"10199\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/vitamin-c\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Vitamin C and Kidney Stone Risk \u2014 Avoid More Than 1,000 mg per Day\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Vitamin C citrus fruits and supplements \u2014 high-dose supplementation above 1,000 mg a day is metabolised into oxalate and raises kidney stone risk\" class=\"wp-image-10199\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Vitamin-C.jpg?resize=18%2C12&amp;ssl=1 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Vitamin C from food is fine; high-dose supplements are the issue, because excess ascorbate becomes oxalate.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Citrate: The Stone Inhibitor<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Citrate binds calcium in the urine and raises urine pH, making crystals less likely to form. It is one of the few things that actively works against stones rather than merely not causing them.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Natural sources:<\/strong> lemon and lime. Roughly half a cup of pure lemon juice diluted through the day provides a useful citrate load. <strong>Use unsweetened preparations<\/strong> \u2014 commercial lemonade carries a sugar load that works against you if weight or metabolic syndrome is part of the picture.<\/li>\n\n\n\n<li><strong>Medical citrate:<\/strong> potassium citrate is the mainstay for uric acid stones and for patients with low urinary citrate. It is prescribed and monitored rather than self-started \u2014 over-alkalinisation causes its own problems.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">When Prevention Is Not Enough: ESWL<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Extracorporeal shock wave lithotripsy (ESWL)<\/strong> uses focused shock waves to break stones into fragments small enough to pass in the urine. For how the technology developed, see <a href=\"https:\/\/drsoaraweeurology.com\/2026\/05\/06\/evolution-of-stone-treatment-eswl\/\">the evolution of ESWL<\/a>, and the wider <a href=\"https:\/\/drsoaraweeurology.com\/services\/kidney-stone-treatment-bangkok\/\">kidney stone service<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">At <strong>Bangkok Hospital Headquarters, ESWL is performed with a 3rd-generation lithotripter as a same-day daycare procedure<\/strong>, using short-acting analgesia rather than general anaesthesia. Lithotripter generations differ mainly in how the stone is located and how comfortable treatment is:<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th>Feature<\/th><th>3rd generation<\/th><th>4th generation<\/th><\/tr><\/thead><tbody><tr><td><strong>Targeting<\/strong><\/td><td>X-ray fluoroscopy, exposure kept as low as reasonably achievable<\/td><td>Ultrasound localisation, no X-ray needed<\/td><\/tr><tr><td><strong>Comfort<\/strong><\/td><td>Short-acting intravenous analgesia or light sedation commonly given<\/td><td>Often tolerated with little or no analgesia<\/td><\/tr><tr><td><strong>Accuracy<\/strong><\/td><td>The stone moves with breathing; aim is checked and corrected by the operator<\/td><td>Automatic ultrasound respiratory tracking<\/td><\/tr><tr><td><strong>Recovery<\/strong><\/td><td>Daycare; admission only if complications or other conditions require it<\/td><td>Daycare, same-day discharge<\/td><\/tr><\/tbody><\/table><figcaption class=\"wp-element-caption\">How lithotripter generations differ. Both treat stones effectively; the differences are in targeting and comfort.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">How Well It Works \u2014 and What Changes the Answer<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Published series of respiratory-tracking systems report better targeting accuracy than untracked treatment, and stone-free rates in the region of four in five patients at three-month follow-up. Those figures come from manufacturer-associated and single-centre studies rather than independent randomised comparisons, so treat them as indicative rather than as a promise.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What actually drives your own chance of success matters more than the generation of machine: <strong>stone size, stone composition, where it sits in the kidney, the distance from skin to stone, and whether anything downstream is obstructing.<\/strong> Very hard stones and lower-pole stones do less well, and some stones need more than one session or a different approach altogether. That assessment is what a consultation is for.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Risks and Who Should Not Have It<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">ESWL is non-invasive, not risk-free, and any honest account includes this list.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Blood in the urine and bruising over the flank<\/strong> are common in the first day or two and settle.<\/li>\n\n\n\n<li><strong>Pain as fragments pass<\/strong> \u2014 expected, and manageable with the medication you are sent home with.<\/li>\n\n\n\n<li><strong>Steinstrasse<\/strong> \u2014 a column of fragments blocking the ureter. This is the complication to know about: increasing pain, or pain with fever, after treatment means being seen rather than waiting it out.<\/li>\n\n\n\n<li><strong>Bleeding around the kidney<\/strong> is uncommon but real, and more likely with uncontrolled blood pressure or on blood-thinning medication.<\/li>\n\n\n\n<li><strong>Infection<\/strong>, which is why urine is checked and cleared beforehand.<\/li>\n\n\n\n<li><strong>Retreatment<\/strong> is sometimes needed; one session does not always finish the job.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">ESWL is generally <strong>not suitable in pregnancy<\/strong>, with an untreated urinary infection, with a bleeding disorder or uncorrected anticoagulation, or where there is an obstruction below the stone that fragments could not pass. Tell your urologist about every medicine you take, particularly anything that thins the blood \u2014 and do not stop it yourself.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"433\" height=\"614\" data-attachment-id=\"9947\" data-permalink=\"https:\/\/drsoaraweeurology.com\/bn\/june-2019-with-arjan-damrongpan-1\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-1.webp?fit=433%2C614&amp;ssl=1\" data-orig-size=\"433,614\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Overflow audience \u2014 Royal Phnom Penh seminar, June 2019\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Royal Phnom Penh Hospital urology seminar audience overflow, June 2019 \u2014 Cambodia urology event&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-1.webp?fit=433%2C614&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-1.webp?resize=433%2C614&#038;ssl=1\" alt=\"Audience at the Royal Phnom Penh Hospital urology seminar, June 2019\" class=\"wp-image-9947\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-1.webp?w=433&amp;ssl=1 433w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-1.webp?resize=212%2C300&amp;ssl=1 212w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/June-2019-With-Arjan-Damrongpan-1.webp?resize=8%2C12&amp;ssl=1 8w\" sizes=\"(max-width: 433px) 100vw, 433px\" \/><figcaption class=\"wp-element-caption\">The Royal Phnom Penh Hospital urology seminar, June 2019.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Take-Home Messages<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stones are common and largely manageable<\/strong> \u2014 but they recur, and prevention is a long-term habit rather than a course of treatment.<\/li>\n\n\n\n<li><strong>Do not cut out calcium.<\/strong> Cut back on salt, moderate the high-oxalate foods, and pair them with calcium in the same meal.<\/li>\n\n\n\n<li><strong>Fluid is the highest-yield change<\/strong>, aiming for urine that stays pale.<\/li>\n\n\n\n<li><strong>Keep any stone you pass.<\/strong> Composition changes the entire prevention plan.<\/li>\n\n\n\n<li><strong>ESWL is recommended by European guidelines for most stones under 2 cm<\/strong>, with the best single-session results in stones under 1 cm \u2014 but suitability depends on the individual stone.<\/li>\n\n\n\n<li><strong>Fever with flank pain is the emergency<\/strong> that all of the above is trying to prevent.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th>Nutrient<\/th><th>General target for stone formers<\/th><\/tr><\/thead><tbody><tr><td><strong>Fluids<\/strong><\/td><td>More than 2.5 litres a day, more in heat; individualised if fluids are restricted for other reasons<\/td><\/tr><tr><td><strong>Calcium<\/strong><\/td><td>800-1,200 mg a day, preferably from food and taken with meals<\/td><\/tr><tr><td><strong>Oxalate<\/strong><\/td><td>Moderate the high-oxalate foods rather than eliminate them; pair with calcium<\/td><\/tr><tr><td><strong>Sodium<\/strong><\/td><td>2,000-3,000 mg a day<\/td><\/tr><tr><td><strong>Protein<\/strong><\/td><td>0.8-1.4 g per kg per day<\/td><\/tr><tr><td><strong>Vitamin C<\/strong><\/td><td>Food is fine; avoid supplements above 1,000 mg a day<\/td><\/tr><\/tbody><\/table><figcaption class=\"wp-element-caption\">General dietary targets for stone formers. Individual plans follow stone analysis and, where indicated, metabolic evaluation.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">If you are dealing with kidney stones or want a prevention plan based on your own stone composition and metabolic profile, Dr. Soarawee Weerasopone consults at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Bangkok Hospital Headquarters<\/a> and at <a href=\"tel:0880221445\">Samitivej Sriracha Hospital, Chonburi \u2014 088-022-1445<\/a>. For questions about the cost of ESWL or any other procedure, please email the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>, who handle all pricing enquiries.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. It suits reviewing imaging, stone analysis results and a prevention plan; acute flank pain with fever needs an emergency department rather than a teleconsultation. Samitivej Sriracha is in-person only.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Kidney Stone Prevention<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">How much water should I drink to prevent kidney stones?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">More than 2.5 litres a day is the usual recommendation, and more in hot weather or with heavy sweating. The practical marker is urine that stays pale through the day. If you have heart failure or significant kidney impairment, or have been advised to restrict fluids, agree your target with your doctor rather than following a general figure.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Should I avoid calcium if I have calcium kidney stones?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No \u2014 this is the most common misconception in stone prevention, and it is backwards. Low dietary calcium leaves more oxalate free to be absorbed and raises stone risk. Aim for 800 to 1,200 mg a day, preferably from food, and take any supplement with meals so the calcium binds oxalate in the gut.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Does lemon juice really help prevent kidney stones?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It helps. Lemon and lime are rich in citrate, which binds calcium in the urine and raises urine pH so crystals are less likely to form. Use unsweetened preparations \u2014 commercial lemonade carries a sugar load that works against you. For patients who need more citrate than diet provides, prescribed potassium citrate is the medical option.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What size of kidney stone is best treated with ESWL?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">European Association of Urology guidance supports ESWL for most stones under 2 cm, with the best single-session results in stones under 1 cm. Size is not the only factor: composition, position in the kidney, the distance from skin to stone and any obstruction below it all affect whether ESWL is the right choice.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What are the risks of ESWL?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Blood in the urine and flank bruising are common and settle. Pain as fragments pass is expected. The complication to know about is steinstrasse, a column of fragments blocking the ureter \u2014 increasing pain, or pain with fever, after treatment means being seen rather than waiting. Bleeding around the kidney is uncommon but more likely with uncontrolled blood pressure or blood-thinning medication, and retreatment is sometimes needed. ESWL is generally avoided in pregnancy, with an untreated infection, with a bleeding disorder, or where an obstruction lies below the stone.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">When is a kidney stone an emergency?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Fever or shaking chills with flank pain is the critical one: a blocked kidney that is also infected can progress to sepsis within hours and needs drainage rather than antibiotics alone. Also go in for pain that painkillers do not touch, persistent vomiting, passing little or no urine, or flank pain in pregnancy, in a single kidney, or with known kidney impairment.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2026\/05\/13\/kidney-stone-prevention-management-guide\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2026\/05\/13\/kidney-stone-prevention-management-guide\/\",\n      \"name\": \"Kidney Stone Prevention and Management: A Modern Guide to Staying Stone-Free\",\n      \"description\": \"How kidney stones form, the dietary changes that genuinely reduce recurrence, where ESWL fits, its risks and contraindications, and the symptoms that make a stone an emergency.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2026-05-13\",\n      \"dateModified\": \"2026-08-16\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2026\/05\/13\/kidney-stone-prevention-management-guide\/#urolithiasis\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"Fever or rigors with flank pain indicates a possibly infected obstructed kidney requiring emergency drainage. 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Always consult a qualified healthcare professional before starting or changing any medical treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Kidney stones are one of the most common urological problems \u2014 and one of the most preventable. Dr. Soarawee Weerasopone, urologist at Bangkok Hospital, explains why stones form, the habits that genuinely reduce recurrence, and when treatment such as ESWL becomes necessary.<\/p>","protected":false},"author":185281453,"featured_media":10234,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"Dr. Soarawee, urologist at Bangkok Hospital, shares evidence-based dietary prevention, the role of citrate, and how ESWL treats kidney stones as a non-invasive, same-day procedure.","jetpack_seo_html_title":"Kidney Stone Prevention & Treatment: A Urologist's Modern Guide | Dr. Soarawee","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1],"tags":[],"class_list":["post-10194","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kidney-stone"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-2Eq","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/05\/Kidney-Stone-Prevention-Management.jpg?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts\/10194","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/comments?post=10194"}],"version-history":[{"count":14,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts\/10194\/revisions"}],"predecessor-version":[{"id":11499,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/posts\/10194\/revisions\/11499"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/media\/10234"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/media?parent=10194"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/categories?post=10194"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/bn\/wp-json\/wp\/v2\/tags?post=10194"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}