Behavioral Interventions for the Prevention and Treatment of Urolithiasis – A Review

Abstract

Urolithiasis is a common and recurrent condition associated with significant clinical and
economic burden. Despite well-established recommendations regarding fluid intake and
dietary modification, long-term adherence to preventive measures remains low. In recent
years, behavioral interventions—particularly those supported by digital technologies—have
emerged as promising tools to improve adherence and reduce recurrence risk. This narrative
review summarizes and evaluates current evidence on behavioral interventions used in the
prevention and treatment of kidney stone disease, including health coaching, reminder
systems, mobile applications, smart hydration devices, nudging strategies, and structured
problem solving approaches. The available data indicate that digital and behaviorally
informed interventions consistently improve short-term fluid intake and 24-hour urine
volume; however, evidence for sustained reduction in stone recurrence remains limited.
Large randomized trials suggest that hydration-focused behavioral strategies alone may be
insufficient to influence long-term clinical outcomes in unselected populations. Future
research should focus on integrated, personalized interventions combining behavioral support
with metabolic evaluation, dietary modification, and pharmacotherapy, as well as long-term
maintenance strategies. Such approaches may offer the greatest potential for reducing
recurrence and improving quality of life in patients with urolithiasis.