Did you know that one in ten people will develop a kidney stone in their lifetime? Recent studies have shown that the incidence of kidney stones is on the rise across the country. Those in the know believe some major misconceptions may be to blame.

The National Kidney Foundation has partnered with Dr. Allan Jhagroo, a kidney stone specialist at the University of Wisconsin School of Medicine and Public Health, to help you stay stone-free by debunking some of the top myths and misconceptions about kidney stones.

Don’t underestimate your sweat.

Saunas, hot yoga, and heavy exercise can be good for your health, but they can also lead to kidney stones. Why? Losing water through sweat—whether from these activities or just the summer heat—leads to less urine production. The more you sweat, the less you urinate, which allows stone-causing minerals to settle and bind in the kidneys and urinary tract.

One of the best measures you can take to avoid kidney stones is to drink plenty of water, which leads to frequent urination. So make sure you stay well hydrated, especially when you engage in exercise or activities that cause you to sweat a lot.

It’s not just oxalate.

Oxalate occurs naturally in many foods, including fruits and vegetables, nuts and seeds, grains, legumes, and even chocolate and tea. Some examples of foods that contain high levels of oxalate include peanuts, rhubarb, spinach, beets, chocolate, and sweet potatoes. Moderate intake of these foods may be beneficial for people who form calcium oxalate stones, the main type of kidney stone. A common misconception is that limiting only oxalate-rich foods in your diet will reduce the likelihood of calcium oxalate kidney stones. While this may be true in theory, this approach is not smart from an overall health perspective. Most kidney stones form when oxalate binds to calcium while urine is produced by the kidneys. It is important to eat and drink foods rich in calcium and oxalates together during meals. In doing so, oxalate and calcium are more likely to bind together in the stomach and intestines before the kidneys begin to process them, making kidney stones less likely to form.

Calcium is not the enemy.

But it tends to get a bad rap! Most likely due to its name and composition, many are under the impression that calcium is the main culprit behind calcium oxalate stones. “I still see patients who wonder why their stones keep coming back even though they’re restricting their calcium intake,”. “I’ve even had patients say their doctors told them to reduce their calcium intake.” A diet low in calcium increases the risk of kidney stones. Do not reduce calcium. Work to reduce sodium in your diet and pair calcium-rich foods with oxalate-rich foods.

It’s not one-and-done.

Passing a kidney stone is often described as one of the most painful experiences a person can go through, but unfortunately, it is not always a one-time event. Studies have shown that having even one stone significantly increases your chances of another. “Most people will want to do whatever it takes to make sure it doesn’t happen again,” said Dr. Jhagroo. “Unfortunately, people don’t seem to make the necessary changes after their first brick-and-mortar event.”Research conducted by Dr. Jhagroo shows that people with kidney stones don’t always heed the advice of their nephrologists and urinary specialists. About 15% of patients with kidney stones did not take prescribed medication and 41% did not follow nutritional advice to prevent stone recurrence. Without the right medication and dietary changes, stones can return, and recurring kidney stones could also be an indicator of other problems, including kidney disease.

When life hands you kidney stones.

And as they say “make lemonade”. It is important to consider dietary remedies alongside prescription medications. The next time you drive past a soda stand, think about your kidneys. Chronic kidney stones are often treated with an alkaline (less acidic) citrate, such as potassium citrate, which helps prevent certain stones when urinary citrate is low and urine pH levels are too low (or too acidic). Citrus juices contain citrate (citric acid), but large amounts may be needed. Also, watch out for sugar. A lemon juice concentrate (4 ounces daily) mixed with water may be considered. Alkaline citrate can be prescribed and is available over the counter. Alkaline citrate may be given with a mineral(s) such as sodium, potassium, or magnesium to prevent stone formation. The goal is to increase the citrate content of the urine (to prevent calcium stones) and to increase the pH of the urine (or make the urine less acidic or more alkaline, to prevent the formation of urinary and cystine stones). The goal is to keep the pH balanced. Talk to your doctor or other healthcare professional about which treatment options are right for you, including over-the-counter products and home remedies. People with kidney disease may need to watch their intake of sodium, potassium, or other minerals depending on the stage of their kidney disease or other factors.

Not all stones are created equal.

In addition to calcium oxalate stones, another common type of kidney stone is uric acid stones. Red meat, organ meats, and shellfish have high concentrations of natural chemical compounds known as purines. “A high intake of purines leads to higher uric acid production and creates a greater acid load for the kidneys to excrete,” Dr. Jhagroo said. Higher uric acid excretion leads to a decrease in overall urine pH, meaning the urine is more acidic. A high concentration of acid in the urine facilitates the formation of uric acid stones. To prevent uric acid stones, limit foods high in purines, such as red meat, organ meats, and shellfish, and eat a healthy diet that includes mostly vegetables and fruits, whole grains, and low-fat dairy products. Limit sugar-sweetened foods and drinks, especially those containing high-fructose corn syrup. Limit alcohol as it can raise blood uric acid levels and avoid crash diets for the same reason. Eating less animal protein and eating more fruits and vegetables will help reduce the acidity of the urine, which will help reduce the likelihood of stone formation.