After an individual has passed a kidney stone, the physician usually orders a careful metabolic workup, and has the stone analyzed to identify its exact composition. The workup may include several blood tests, and the individual may be asked to collect 24 hour urine samples.

The urine tests enable the doctor to determine if hypercalciuria (an abnormal level of calcium in the urine), hypocitraturia (low levels of citrate in the urine) or hyperuricosuria (excessive uric acid in the urine) are present. Individuals with these conditions account for about two-thirds of those with calcium stone disease.

In some cases, diuretics, or "water pills" such as hydrochlorothiazide may be prescribed to reduce calcium in the urine. These medications are often effective in preventing recurrence of calcium stones. Individuals with high levels of calcium in their urine, termed hypercalciuria who also have high levels of uric acid in the urine, or hyperuricosuria, may be treated with a drug called Allopurinol. This medication is also used to treat gout.

Individuals with hypercalciuria often can control stone formation simply by drinking a lot of fluids and following a moderate (800-1200mg per day) calcium diet. Some individuals with hypercalciuria may also be placed on a low oxalate and low sodium diet.

Physicians sometimes find that by using chemical agents to manipulate the pH of the urine, crystal formation can be inhibited and stone formation prevented.

An age-old treatment, increasing the patient's daily consumption of liquids (primarily water) is a worthwhile preventive measure regardless of the type of stones involved. On average people with a history of kidney stones are advised to drink 3 liters (13 cups) of fluid a day.

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