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Why Kidney Stone Patients Should Not Restrict Calcium — Stone Formation Chemistry, Urine Concentration, and the 2-Litre Target

Approximately 50% of kidney stone patients have a recurrence within 5 years — and inadequate hydration is the single most modifiable risk factor, because concentrated urine allows crystals to nucleate before being flushed out. Here's the stone formation chemistry for each type (calcium oxalate, uric acid, struvite, cystine), why restricting dietary calcium actually increases oxalate stone risk, why 2 litres of urine output requires approximately 3 litres of fluid intake, and why lemon juice increases urinary citrate as a validated dietary intervention.