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To help prevent recurrent nephrolithiasis, the American College of Physicians recommends: a) increased fluid intake throughout the day to achieve at least 2 L of urine per day; and b) if increased fluid intake fails, monotherapy with a thiazide diuretic, citrate, or allopurinol is recommended in patients with active disease. Both of these recommendations from the ACP are graded as "weak." Ann Intern Med. 2014 Nov 4;161(9):659-67    (retrieved Nov, 2014). There are currently 1090 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2024 by the Internet Medical Association. Click Here to view more medical pearls.