What are your recommendations for stone prevention for patients with recurrent calcium based nephrolithiasis who consume well water with a high calcium concentration?

Drink lots of it! Seriously, studies done long ago, looking at the geography of stone formers did not correlate with water hardness (mineral content), but rather with average temperature, the incidence of stone passage being higher in the southern parts of the United States. The amount of calcium contained in the minimum recommendation of at least 2 quarts of water daily is actually rather small compared to other dietary calcium sources.

Stephen B. Erickson, MD