Lifestyle Medicine and Kidney Stones in Viet Nam: Fluid Intake, Stone Composition, and Recurrence Prevention

Lifestyle Medicine and Kidney Stones in Viet Nam: Fluid Intake, Stone Composition, and Recurrence Prevention

Last reviewed: October 30, 2026

Removing a kidney stone may solve the immediate problem, but it does not necessarily prevent another stone from forming. Once the pain has resolved and treatment is completed, many patients receive familiar advice: drink more water, eat less salt and avoid certain foods. These recommendations can be useful, but they do not always explain why the stone developed or what is needed to reduce the risk of recurrence.

Consider two people who have both undergone treatment for kidney stones. One may have a calcium oxalate stone associated with low urine volume and excessive sodium intake. The other may have a uric acid stone that developed primarily because their urine is persistently acidic. Both could benefit from appropriate hydration, but their additional prevention strategies may be quite different.

This is where Lifestyle Medicine can contribute to long-term care. Rather than treating hydration and dietary changes as isolated recommendations, an evidence-based approach connects daily behaviors with stone composition, metabolic findings, medical conditions and the circumstances in which people live.

For healthcare professionals in Viet Nam, the opportunity is to make recurrence prevention more personalized and practical while ensuring that lifestyle interventions remain connected to appropriate urological assessment, medical treatment and follow-up.

Understanding Why Stone Composition Matters

Kidney stones, also called renal calculi, form when certain substances in urine become sufficiently concentrated to crystallize. Their development involves several interacting factors, including urine volume, urinary calcium, oxalate, uric acid, citrate and urine pH.

Anatomical abnormalities, urinary infections, inherited disorders, gastrointestinal conditions and certain medications can also contribute. Knowing what a stone contains can therefore provide useful information about the processes involved in its formation.

A study conducted at Binh Dan Hospital in Ho Chi Minh City, published in BMC Urology on April 13, 2026, examined 765 stone samples collected from 743 patients undergoing surgical treatment for renal or ureteral stones between July 2023 and April 2025.

The researchers used infrared spectroscopy and X-ray diffraction to determine stone composition. Calcium oxalate was the most common stone type, accounting for 63.4% of samples. The study also found that 58.56% of stones contained mixed mineral components.

These findings illustrate why stone analysis can provide information that may not be apparent from imaging or symptoms alone. A single stone may contain several minerals, and its predominant component does not necessarily explain every factor contributing to its formation.

However, the study involved patients requiring surgical treatment at a tertiary hospital. The findings should not be interpreted as representing the distribution of kidney stone types across Viet Nam. People with smaller stones, uncomplicated disease or stones managed without surgery may have different characteristics.

Nevertheless, the study provides locally relevant evidence supporting the value of stone composition analysis.

The American Urological Association published updated guidance on the medical management of kidney stones in July 2026. It recommends obtaining stone analysis when a suitable specimen is available and previous analysis has not been performed. The European Association of Urology similarly emphasizes reliable stone analysis as part of the evaluation of patients with urinary stones.

This information matters because calcium oxalate, calcium phosphate, uric acid, cystine and infection-related stones do not have identical mechanisms or prevention requirements.

When stone composition is unknown, clinical history, laboratory investigations, imaging and recurrence risk can still guide management. The absence of a stone sample should not prevent appropriate prevention advice, but uncertainty about composition should be recognized rather than replaced with assumptions.

Hydration: Urine Volume Matters More Than a Fixed Number of Glasses

Increasing fluid intake is one of the most established strategies for reducing kidney stone recurrence. Producing more urine lowers the concentration of substances that can crystallize and contribute to stone formation.

However, the amount of water consumed and the amount of urine produced are not interchangeable.

The updated 2026 American Urological Association guideline recommends that adults with a history of calcium-based kidney stones consume sufficient water to produce at least 2.5 liters of urine per day. It also recommends appropriate urine volume targets for other stone types, while the European Association of Urology supports maintaining a high urine volume as a general preventive strategy.

The important distinction is that 2.5 liters refers to daily urine output, not a universal instruction to drink exactly 2.5 liters of water.

Fluid requirements vary according to physical activity, perspiration, environmental temperature, gastrointestinal fluid losses and individual physiology. Someone working outdoors in hot weather may need considerably more fluid to achieve the same urine volume as someone working in an air-conditioned office.

This is particularly relevant in Viet Nam, where agricultural workers, construction workers, delivery personnel and others who spend prolonged periods outdoors may experience substantial fluid loss through sweating.

Maintaining adequate hydration may also be difficult for practical reasons. Access to safe drinking water, opportunities to take breaks, working schedules and toilet availability can influence whether a recommended drinking routine is realistic.

Someone may understand why hydration matters but still find it difficult to drink regularly throughout the working day.

For patients who can safely increase fluid intake, spreading water consumption across the day is generally more practical than drinking large amounts at once. Water is usually the preferred beverage.

There is no established need to rely on commercially marketed alkaline water, detoxification drinks or specialty mineral water as a routine requirement for kidney stone prevention. Evidence supporting increased urine volume should not be confused with proof that a particular branded beverage prevents recurrence.

Frequent consumption of sugar-sweetened soft drinks also offers no necessary advantage. The updated American guidance supports limiting soft drinks in appropriate patients, while ensuring that any reduction is accompanied by sufficient replacement fluid to maintain adequate urine volume.

Nevertheless, higher fluid intake is not appropriate for everyone.

People with heart failure, advanced kidney disease, prescribed fluid restrictions or other disorders affecting fluid balance may be harmed by indiscriminately increasing water consumption. Excessive water intake can also cause electrolyte disturbances, including hyponatremia.

Patients with cystinuria often require higher urine volume targets under specialist supervision. Children have requirements based on age and body size and should not automatically be given adult hydration targets.

The appropriate approach is to establish a safe and achievable hydration plan according to stone type, recurrence risk and other medical conditions.

Calcium Oxalate Stones: Why Restricting Calcium Can Be Counterproductive

Calcium oxalate stones are common, but their name can create an important misunderstanding.

Some patients assume that because their stone contains calcium, they should avoid calcium-rich foods. They may stop drinking milk, remove yogurt from their diet or limit other important calcium sources without professional advice.

This can be counterproductive.

Adequate dietary calcium helps bind oxalate in the intestine, reducing the amount available for absorption. When dietary calcium is unnecessarily restricted, more oxalate may be absorbed and subsequently excreted in urine, potentially increasing calcium oxalate stone risk.

For many adults with calcium stones, maintaining normal dietary calcium intake, generally around 1,000–1,200 milligrams daily according to individual nutritional needs, is preferable to following a low-calcium diet.

The source and timing of calcium also matter. Obtaining calcium through ordinary foods and consuming calcium-containing foods with meals may help reduce intestinal oxalate absorption.

Calcium supplements require separate consideration. They may be appropriate when dietary intake is insufficient or another medical indication exists, but the decision should account for stone risk, urinary findings, bone health and other clinical factors.

In selected patients with enteric hyperoxaluria, calcium supplementation taken with meals may have a specific therapeutic role. This is different from recommending routine calcium supplementation to everyone with kidney stones.

Oxalate intake also requires an individualized approach.

Certain leafy vegetables, nuts, seeds and other plant foods contain substantial amounts of oxalate. However, this does not justify automatically excluding vegetables, fruit, nuts or other plant foods from the diet.

When urinary oxalate is elevated, healthcare professionals can review frequently consumed foods, portion sizes, calcium intake and possible gastrointestinal causes.

For example, someone consuming large quantities of high-oxalate foods daily may require a different approach from someone who eats those foods occasionally as part of a varied diet.

Gastrointestinal conditions can also influence stone risk. People with fat malabsorption, certain forms of inflammatory bowel disease, short bowel syndrome or previous intestinal surgery may develop enteric hyperoxaluria, in which increased intestinal oxalate absorption contributes to elevated urinary oxalate.

These patients may require specialized nutritional assessment rather than general dietary restriction alone.

High-dose vitamin C supplementation is another consideration. Some vitamin C is metabolized to oxalate, and excessive supplementation may increase urinary oxalate in susceptible individuals. This concern should not be confused with ordinary consumption of vitamin C from food.

Patients using high-dose vitamins, concentrated plant extracts or supplements marketed for kidney cleansing should discuss these products with appropriately qualified healthcare professionals.

The objective is not to eliminate as many foods as possible. It is to identify relevant dietary contributors while maintaining adequate nutrition, bone health and dietary variety.

Sodium, Animal Protein and Vietnamese Eating Patterns

Excessive dietary sodium is relevant to calcium stone formation because higher sodium intake can increase urinary calcium excretion.

In Viet Nam, sodium may come from added salt, fish sauce, soy sauce, seasoning powders, preserved foods, processed products, instant noodles and certain soups or broths.

Two people eating similar meals may consume quite different amounts of sodium depending on how the food is prepared and how much seasoning or dipping sauce they use.

This makes individual dietary assessment more useful than labeling particular traditional Vietnamese dishes as prohibited.

For someone who frequently consumes heavily salted meals, reducing sodium may be a practical way to address stone risk while also supporting blood pressure and cardiovascular health.

Patients should understand that sodium and salt are not identical measurements. One gram of sodium is approximately equivalent to 2.5 grams of sodium chloride.

The European Association of Urology's 2026 guidance recommends limiting excessive salt intake as part of general recurrence prevention. The American Urological Association also emphasizes sodium reduction for appropriate patients with calcium-based stones and elevated urinary calcium.

However, sodium advice should be considered alongside the person's overall dietary pattern, metabolic findings and other medical needs.

Excessive animal protein intake can contribute to urinary changes associated with stone formation, including lower urinary pH, reduced citrate and increased uric acid excretion.

This does not mean that all patients should adopt a low-protein diet.

Adequate protein remains important for maintaining muscle mass, physical function and nutritional health. A person with frailty, malnutrition or increased nutritional requirements may need a different approach from someone consuming large amounts of meat or protein supplements.

For many patients, a balanced dietary pattern containing suitable portions of plant and animal foods may be appropriate.

Predominantly plant-based eating patterns may support broader metabolic health, but they still need to be nutritionally adequate. Particular attention may be needed when someone consumes concentrated plant products or unusually large quantities of high-oxalate foods.

The relevant issue is the overall dietary pattern and the patient's metabolic findings, not whether a single food is labeled healthy or unhealthy.

Different Stone Types Require Different Prevention Strategies

Not every kidney stone is driven primarily by calcium or oxalate.

Calcium phosphate stones may be associated with elevated urinary calcium, relatively alkaline urine or underlying conditions such as distal renal tubular acidosis and primary hyperparathyroidism.

These circumstances may require additional investigation. Treatments that increase urinary pH can be useful for certain stone types, but excessively alkaline urine may favor calcium phosphate crystallization.

Urinary alkalinization should therefore not be treated as a universally beneficial intervention.

Uric acid stones involve a different mechanism.

Persistently acidic urine is a major factor in their formation. Someone may develop uric acid stones even without markedly elevated blood uric acid levels. Conversely, gout or an elevated serum uric acid concentration does not establish that a kidney stone is composed of uric acid.

Adequate hydration, dietary changes and management of relevant metabolic conditions may help, but clinician-supervised urinary alkalinization is often central to preventing uric acid stone recurrence and may help dissolve suitable existing uric acid stones.

The updated 2026 American Urological Association guideline emphasizes urinary alkalinization as the primary pharmacological approach for uric acid stones. It does not recommend xanthine oxidase inhibitors, such as allopurinol or febuxostat, as first-line treatment solely for uric acid stones.

This distinction matters because lowering serum uric acid and correcting persistently acidic urine are not the same intervention.

Cystine stones are associated with cystinuria, an inherited disorder affecting renal amino acid transport. People with cystinuria often require specialist care, higher urine volume targets, urinary alkalinization and, in some cases, additional medicines to improve cystine solubility.

Infection-related stones, particularly those containing struvite, present another clinical challenge.

These stones are associated with infections caused by bacteria that produce urease. Recurrence prevention may require appropriate antimicrobial management and removal of infected stone material.

Dietary changes and hydration cannot replace these interventions.

The differences between stone types illustrate why a single kidney stone diet or supplement regimen is unlikely to meet every patient's needs.

Metabolic Evaluation Can Make Prevention More Precise

Stone analysis identifies what a stone contains, but it does not always explain why the stone formed.

A metabolic evaluation can identify abnormalities that influence future stone formation and guide more specific preventive measures.

The updated 2026 American Urological Association guideline supports one or more 24-hour urine collections in appropriate patients, including higher-risk stone formers, children with stones and motivated individuals following a first stone episode.

The European Association of Urology recommends more detailed metabolic evaluation in higher-risk patients, generally using two consecutive 24-hour urine collections.

Depending on the clinical indication, testing may assess urine volume, pH, calcium, oxalate, uric acid, citrate, sodium, potassium, creatinine and other relevant substances.

The findings can reveal problems that are not apparent from symptoms or routine laboratory results.

One patient may have low urine volume despite reporting frequent water consumption. Another may have elevated urinary calcium associated with excessive sodium intake. A third may have low urinary citrate, reducing one of the natural mechanisms that inhibit stone formation.

These findings can lead to different recommendations.

For someone with low urine volume, the priority may be establishing a more reliable drinking routine. For a patient with elevated urinary calcium, dietary sodium intake and other metabolic contributors may require attention. Someone with low urinary citrate may benefit from additional nutritional assessment or specific medical treatment.

Evaluation can also include kidney function, serum calcium, relevant metabolic conditions, medication history, urinary infections and previous imaging findings.

Selected patients may require investigation for primary hyperparathyroidism, renal tubular disorders or inherited stone diseases.

Children, patients with early-onset stones, those with frequently recurrent stones and people with unusual stone compositions may require particular attention.

Not every patient needs the same investigations. The extent of evaluation should reflect recurrence risk, clinical findings, patient preferences and access to appropriate services.

The timing of testing matters as well. The European Association of Urology advises performing a specific metabolic evaluation after the acute episode has settled, when the person is clinically stable, free of infection and following their usual diet and fluid intake. The guideline recommends waiting at least 20 days after the acute episode, with approximately three months preferred when feasible.

In Viet Nam, access to specialized metabolic investigations may vary between healthcare facilities. Where comprehensive testing is unavailable, clinicians can still provide appropriate general prevention advice while recognizing when referral or further assessment is necessary.

The 2026 American Urological Association guideline also allows selected adults with recurrent stones to be considered for preventive medication even when stone composition or detailed urinary chemistry is unavailable. This is a conditional recommendation, not an endorsement of routine medication use without clinical evaluation.

Such decisions require consideration of recurrence history, the likely stone type, other medical conditions, potential adverse effects and the feasibility of further investigation.

The purpose of metabolic evaluation is not simply to collect more laboratory data. It is to identify abnormalities that can inform meaningful preventive action.

Making Prevention Practical in Everyday Life

Knowing which changes are appropriate does not necessarily mean patients can maintain them.

A construction worker may understand the importance of hydration but have limited opportunities to take breaks. An office worker may drink little water during busy periods. Someone who regularly eats outside the home may find it difficult to estimate sodium intake.

Another person may receive advice to reduce oxalate and respond by avoiding nearly all vegetables.

These situations illustrate why prevention plans should begin with the patient's circumstances rather than a standard list of instructions.

Healthcare professionals can explore usual meals, beverage choices, working conditions, previous stone episodes, current medications and earlier attempts at prevention.

The next step is to identify changes that are clinically relevant and realistic.

For someone with low urine volume, the priority may be better access to drinking water and a routine that fits their working day. For a patient with excessive sodium intake, it may involve adjusting the use of fish sauce, seasoning powders or heavily salted foods without replacing their entire diet.

A person with elevated urinary oxalate may benefit from targeted dietary counseling, including attention to normal calcium intake, rather than extensive food avoidance.

Regular physical activity and healthy weight management can support broader metabolic health, particularly in people with obesity, diabetes or other cardiometabolic risks.

However, exercise itself should not be presented as a proven substitute for stone-specific recurrence prevention. Prolonged physical activity may also increase fluid loss, making appropriate hydration important.

Prevention plans must be coordinated with other medical needs.

Someone with calcium stones and osteoporosis may need particular attention to calcium intake and bone health. A person with kidney stones and chronic kidney disease may have different dietary or fluid requirements from someone with normal kidney function.

A patient with heart failure may already be following an individualized fluid management plan that cannot simply be replaced with a standard stone-prevention recommendation.

The updated Lifestyle Medicine Core Competencies, first published online in 2025 and included in the 2026 journal issue, emphasize evidence-based clinical practice, behavior-change support and attention to the social determinants of health.

These principles are relevant because the effectiveness of a prevention strategy depends partly on whether people can integrate it into everyday life.

A useful plan should be understandable, clinically appropriate and sustainable without creating unnecessary restrictions or conflicts with existing care.

When Lifestyle Measures Are Not Enough

Lifestyle interventions can reduce important stone-forming risks, but they are not sufficient for every patient.

People with recurrent stones, persistent metabolic abnormalities or particular inherited conditions may require preventive medication.

The updated 2026 American Urological Association guideline recommends offering thiazide or thiazide-like diuretics to adults with recurrent calcium-based stones and high or relatively high urinary calcium.

However, the evidence behind these medicines deserves careful interpretation.

The NOSTONE randomized trial, published in The New England Journal of Medicine in 2023, evaluated hydrochlorothiazide at several doses in patients with recurrent calcium stones.

The study did not demonstrate a statistically significant reduction in its primary composite outcome of symptomatic or radiographic stone recurrence or growth compared with placebo. Certain adverse effects were also more common among participants receiving hydrochlorothiazide.

These findings raised important questions about the expected benefits of treatment and the selection of patients most likely to respond.

Nevertheless, the trial does not establish that all thiazide or thiazide-like medicines are ineffective in every patient.

The 2026 American guideline considers the findings alongside other evidence, including urinary calcium levels, sodium intake, treatment duration and differences between shorter-acting and longer-acting medicines.

The guideline also permits consideration of thiazides or alkali therapy in selected adults with recurrent calcium stones when no metabolic abnormality is detected or when stone formation continues despite appropriate correction of identified risk factors.

These are individualized treatment options rather than universal recommendations.

The decision to use preventive medication should therefore involve discussion of expected benefits, uncertainties, adverse effects and monitoring requirements.

Other preventive treatments, including alkali citrate therapy, may be appropriate for selected patients with recurrent calcium stones, low urinary citrate or other relevant metabolic abnormalities.

However, the effect of urinary alkalinization depends on stone composition and urine chemistry.

For example, increasing urinary pH may help prevent uric acid stones but can increase calcium phosphate supersaturation if urine becomes excessively alkaline.

Potassium-containing products may also be unsuitable for people with certain kidney conditions or those taking medicines that increase serum potassium.

The updated American guideline recognizes that some nonprescription alkali preparations can increase urinary citrate or pH. However, formulations vary, and evidence demonstrating long-term prevention of stone recurrence remains limited.

These products should not be regarded as universally effective or harmless simply because they are available without a prescription.

Allopurinol may also have a role in selected patients with recurrent calcium oxalate stones and elevated urinary uric acid, or for other established medical indications.

Its use requires particular attention to medication safety.

The HLA-B*58:01 genetic variant is strongly associated with severe allopurinol-related cutaneous adverse reactions. Relevant international guidance recommends testing before allopurinol initiation in certain higher-risk populations, including people of Southeast Asian ancestry.

This issue has particular relevance to Viet Nam.

A case-control study published in Arthritis Research & Therapy in 2020 identified HLA-B*58:01 and other factors associated with severe allopurinol-related skin reactions among Kinh Vietnamese patients.

Although the study focused on allopurinol safety rather than kidney stone prevention, its findings support careful consideration of genetic and clinical risks when prescribing allopurinol in Vietnamese practice.

Testing and prescribing decisions must reflect the individual's circumstances, applicable professional guidance and available clinical resources.

Preventive medication should be selected and monitored by appropriately qualified healthcare professionals. More treatment is not automatically better when the indication is uncertain or potential harm outweighs the expected benefit.

Recognizing When a Kidney Stone Becomes an Emergency

Long-term recurrence prevention must be distinguished from the management of an acute stone episode.

A patient with severe flank pain may have a ureteral stone causing urinary obstruction. Some stones pass without intervention, while others require medical or urological treatment.

The presence of infection can substantially change the urgency.

Fever or chills accompanying suspected urinary obstruction, markedly reduced urine output, clinical deterioration or signs of sepsis may indicate a serious complication requiring immediate medical assessment.

The European Association of Urology's 2026 guidelines identify an obstructed urinary system complicated by infection or anuria as a urological emergency.

Urgent treatment may require antibiotics, decompression of the obstructed collecting system and subsequent definitive stone management when clinically appropriate.

Patients with a solitary functioning kidney, significant kidney impairment, uncontrolled pain or other high-risk circumstances may also require prompt specialist evaluation.

Drinking additional water, exercising or using herbal preparations cannot replace emergency treatment.

Someone should not assume that severe pain will resolve safely simply because they have previously passed a stone without complications.

For Lifestyle Medicine education, this establishes an essential safety boundary. Advice about hydration and nutrition is relevant to appropriate prevention circumstances, not as a substitute for assessing suspected obstruction, infection or acute kidney injury.

Follow-Up Should Show Whether Prevention Is Working

Preventive care should not end when a patient receives dietary advice or leaves the hospital after stone treatment.

Follow-up provides an opportunity to determine whether recommended changes have been implemented, whether urinary abnormalities have improved and whether new stones are developing.

For selected patients, repeat 24-hour urine testing can help evaluate the metabolic response to dietary or medication changes.

The 2026 American Urological Association guideline recommends considering repeat metabolic testing within approximately three to six months after initiating or modifying preventive treatment, with subsequent follow-up informed by stone activity and clinical risk.

The European Association of Urology suggests an earlier follow-up urine assessment, usually around eight to twelve weeks after starting pharmacological recurrence prevention, with further monitoring according to the response.

These recommendations reflect the importance of checking whether treatment is producing the intended metabolic changes rather than assuming that a recommendation has worked simply because it was given.

Imaging may also be appropriate to assess residual stones, stone growth or recurrence. The updated American guideline supports surveillance imaging at intervals informed by clinical risk and stone activity, often beginning at approximately six to twelve months in suitable patients.

The imaging method should reflect diagnostic needs and radiation exposure considerations. Ultrasound may be particularly useful in children, pregnant patients and people requiring repeated surveillance, while low-dose computed tomography may be appropriate when greater diagnostic detail is necessary.

An improvement in urine chemistry does not, by itself, prove that future stone formation has been prevented. Similarly, the absence of symptoms does not guarantee that no new stones are present.

Urine volume and chemistry provide information about metabolic risk factors. Imaging assesses stone burden. Symptomatic episodes, emergency visits and urological procedures describe the clinical consequences of recurrence.

Patient-reported outcomes matter as well.

Someone may value being able to travel without fear of another painful episode, work outdoors with better access to drinking water or understand which foods they can eat without unnecessary restrictions.

Healthcare organizations can also assess whether stone analysis results are reviewed, higher-risk patients receive appropriate metabolic evaluation and follow-up plans are documented and communicated.

The purpose is not simply to increase the number of laboratory tests or appointments. It is to ensure that important findings lead to appropriate prevention and treatment decisions.

Professional Responsibilities and Legal Boundaries in Viet Nam

Lifestyle Medicine can contribute to kidney stone prevention through evidence-based education, appropriate nutrition, hydration-related behavior change, physical activity and support for long-term self-management.

However, diagnosing kidney stones, interpreting imaging and metabolic investigations, prescribing medication, determining individualized therapeutic fluid or dietary restrictions and managing acute urological complications are regulated clinical activities.

In Viet Nam, the Law on Medical Examination and Treatment No. 15/2023/QH15, together with applicable amendments and implementing regulations, provides the relevant legal framework.

Consolidated Document No. 26/VBHN-VPQH, issued by the Office of the National Assembly on February 26, 2026, reflects the consolidated provisions of the Law.

Healthcare professionals must act within their qualifications, competence, legally authorized professional scope and applicable institutional responsibilities.

Education or certification in Lifestyle Medicine does not independently authorize someone to diagnose kidney stones, prescribe preventive medication, conduct specialized clinical assessments or modify an individualized medical treatment plan beyond their permitted professional responsibilities.

Disease-specific clinical nutrition also requires appropriate professional oversight when delivered as part of medical examination and treatment.

International recommendations from the American Urological Association and European Association of Urology may inform professional education, evidence appraisal and clinical quality improvement.

However, they do not automatically become Vietnamese regulatory requirements or establish the approval, availability, reimbursement or suitability of particular medicines, diagnostic tests or treatment procedures in Viet Nam.

Patient information must also be handled appropriately.

Stone analysis reports, laboratory results, imaging findings, medical histories and identifiable information collected through follow-up or digital monitoring are subject to applicable confidentiality and personal data protection requirements.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/NĐ-CP, both effective January 1, 2026, are relevant to organizations processing identifiable personal health information.

Organizations should establish appropriate lawful processing arrangements, security safeguards and clearly defined responsibilities when collecting, storing or sharing such information.

For the Vietnam Lifestyle Medicine Alliance, the appropriate contribution is professional education, scientific knowledge sharing, critical appraisal of evidence and responsible communication about applying research in healthcare.

Educational content should not be presented as an official Vietnamese clinical guideline, individualized medical advice or authorization to provide regulated medical treatment.

Recurrence Prevention Requires More Than General Healthy Living Advice

Kidney stone prevention illustrates how Lifestyle Medicine can complement established medical care when interventions are selected according to clinical evidence.

Hydration and nutrition matter, but their benefits depend on how they are applied.

Someone with calcium oxalate stones may need attention to urine volume, calcium intake, urinary oxalate and sodium. A person with uric acid stones may require an approach centered on urinary pH. Patients with cystine or infection-related stones often need more specialized management.

The updated 2026 American and European urological guidelines reinforce the importance of connecting recurrence prevention with stone composition, metabolic findings, individual risk and appropriate follow-up.

Evidence from Binh Dan Hospital also highlights the value of understanding stone composition in Vietnamese clinical practice, while emphasizing the need for further locally relevant research.

For healthcare professionals in Viet Nam, an important opportunity is to move beyond general instructions toward prevention plans that patients can understand and realistically maintain.

These plans should preserve adequate nutrition, avoid unsafe fluid recommendations, consider work and family circumstances and remain connected to appropriate medical care.

Success should not be judged by how many foods someone has eliminated, how many supplements they take or how much water they have been told to drink.

It should be reflected in whether identified risks are addressed safely, whether recurrence and complications are reduced and whether patients can maintain preventive care without unnecessary treatment burdens.

Lifestyle Medicine contributes most to kidney stone prevention when it helps translate clinically appropriate recommendations into sustainable daily practices, supported by accurate diagnosis and continuing care.

Selected References

1. Pearle MS, Matlaga BR, Antonelli JA, et al. Medical Management of Kidney Stones: AUA Guideline (2026) Part I: Evaluation of Patients With Kidney Stones and Dietary Management of Patients With Calcium Stones. The Journal of Urology. Published online July 30, 2026. doi:10.1097/JU.0000000000005227.

2. Pearle MS, Matlaga BR, Antonelli JA, et al. Medical Management of Kidney Stones: AUA Guideline (2026) Part II: Treatment and Follow-up of Kidney Stones. The Journal of Urology. Published online July 30, 2026. doi:10.1097/JU.0000000000005228.

3. European Association of Urology. EAU Guidelines on Urolithiasis. 2026 edition. Sections on metabolic evaluation, recurrence prevention and management of urinary stone emergencies.

4. Nguyen XC, Do AT, Ho HL, Nguyen VH. Stone Composition in Patients Undergoing Surgical Treatment for Kidney Stones: A Cross-Sectional Study at a Tertiary Hospital in Vietnam. BMC Urology. 2026;26:128. Published April 13, 2026. doi:10.1186/s12894-026-02143-z.

5. Dhayat NA, Bonny O, Roth B, et al. Hydrochlorothiazide and Prevention of Kidney-Stone Recurrence. The New England Journal of Medicine. 2023;388(9):781–791. doi:10.1056/NEJMoa2209275.

6. FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis & Rheumatology. 2020;72(6):879–895. doi:10.1002/art.41247.

7. Do MD, Mai TP, Do AD, et al. Risk Factors for Cutaneous Reactions to Allopurinol in Kinh Vietnamese: Results From a Case-Control Study. Arthritis Research & Therapy. 2020;22:182. doi:10.1186/s13075-020-02273-1.

8. Rea BL, Cheema S, Lanza S, et al. Lifestyle Medicine Core Competencies: 2025 Update. American Journal of Lifestyle Medicine. 2026;20(3):443–451. First published online October 28, 2025. doi:10.1177/15598276251379821.

9. National Assembly of Viet Nam. Law No. 15/2023/QH15, dated January 9, 2023. Law on Medical Examination and Treatment.

10. Office of the National Assembly of Viet Nam. Consolidated Document No. 26/VBHN-VPQH, dated February 26, 2026. Law on Medical Examination and Treatment.

11. National Assembly of Viet Nam. Law No. 91/2025/QH15, dated June 26, 2025. Law on Personal Data Protection. Effective January 1, 2026.

12. Government of Viet Nam. Decree No. 356/2025/NĐ-CP, dated December 31, 2025. Detailing Certain Articles and Measures for the Implementation of the Law on Personal Data Protection. Effective January 1, 2026.

Editorial, Clinical and Legal Disclaimer

This article is published by Vietnam Lifestyle Medicine Alliance (VLMA) for general information and professional education. VLMA is a physician-led professional education and knowledge-sharing initiative operated by Vietnam Lifestyle Medicine Alliance Company Limited. The article presents an evidence-informed discussion of Lifestyle Medicine in kidney stone recurrence prevention and does not constitute an official clinical practice guideline, individualized medical advice, a diagnosis, a hydration prescription, a therapeutic diet, a medication recommendation or a treatment plan.

Hydration, nutrition and other lifestyle interventions may contribute to kidney stone prevention but must not replace appropriate urological assessment, metabolic investigation, medical treatment or follow-up.

The information must not be used to independently determine stone composition, diagnose kidney stones, interpret laboratory or imaging findings, establish individualized fluid or dietary targets, initiate or discontinue medication, use urine-alkalinizing products as treatment, or manage suspected urinary obstruction or infection without appropriate professional assessment.

People experiencing severe or persistent flank pain, fever or chills with suspected urinary obstruction, markedly reduced urine output, signs of systemic illness or other concerning symptoms require prompt medical evaluation. Urinary obstruction complicated by infection or sepsis is a medical emergency that may require urgent urological intervention.

The hydration targets and treatment approaches discussed in this article are not universally appropriate. People with heart failure, advanced kidney disease, fluid restrictions, electrolyte disorders, pregnancy-related concerns or other relevant clinical conditions require individualized assessment.

International recommendations discussed in this article do not automatically constitute Vietnamese clinical standards or establish the regulatory approval, availability, reimbursement or suitability of particular medicines, supplements, diagnostic tests or treatment procedures in Viet Nam.

All regulated clinical activities must be undertaken by appropriately qualified healthcare professionals acting within their legally authorized scope of practice and applicable requirements governing healthcare facilities in Viet Nam.

This article does not endorse any commercial mineral water, alkaline water, detoxification product, herbal remedy, supplement, medication brand, diagnostic service or healthcare provider. Identifiable personal health information must be handled in accordance with applicable confidentiality and personal data protection requirements.

The content reflects the scientific evidence, professional recommendations and legal sources reviewed as of October 30, 2026, and may require updating as further research, clinical guidance and Vietnamese regulatory requirements evolve.