Do you prefer still over carbonated water for your patients with recurrent nephrolithiasis who have chronically low urine volumes?

My main concern is hydration. Stone formers tend to be un-thirsty folks, and it is hard to get them to drink anything, let alone my minimum of 2L daily.

Generally I recommend plain water; old research found no difference between hard and soft water. To the extent that carbonated water alkalinizes urine, I would avoid it in calcium phosphate stone formers and encourage it for uric acid stone formers.

Stephen B. Erickson, MD