[Correspondence] PUSH trial limits: why fluids still matter – Authors' reply

We read with interest the Correspondence from Alba Martina Renzullo and Simone Benvenuto regarding results of the Prevention of Urinary Stones with Hydration (PUSH) trial,1 and share their goal of avoiding potentially harmful interpretation of the results.

Findings from the PUSH trial should not undermine the clinical aim of high fluid intake for stone prevention stipulated by current guidelines and supported by one prospective trial.2 Rather, the appropriate conclusion from PUSH is that individuals often struggle to reach the target urine output of 2·5 L per day, despite state-of-the-art adherence support (ie, an evidence-based multicomponent behavioural intervention). ...