Kidney Stones Child

Causes

Some of the known causes of kidney stones in children include:

• Too much oxalate in the urine
• Too much calcium in the urine or blood
• Too much uric acid in the urine
• A stone forms around bacteria
• Inherited issue with how the body handles cystine
• Foreign bodies in the urinary tract, such as stents or catheters
• Urinary tract is not working as it should, such as neurogenic bladder

Risk Factors

Things that may raise a child’s chance of having kidney stones include:

• Dehydration—not drinking enough fluids
• Eating foods high in salt
• Eating a ketogenic diet to help control epilepsy
• The water a child drinks has a lot minerals in it
• Having family members who have had kidney stones or gout
• Having kidney stones in the past
• Being overweight
• Health issues such as urinary tract infections or metabolic conditions
• Where they live—people living in the Southeast United States have a higher risk
• Not being very active
• Having a catheter or something that is not found in the urinary tract

Symptoms

Kidney stones sometimes do not cause symptoms and leave the body in the urine (pee). Often a child with a kidney stone can have:

• Sudden, severe pain in the side of the body or mid- or lower back during movement
• Pain in the belly or groin area
• Nausea or vomiting
• Blood in the urine
• Burning pain when urinating
• Fever
• Recurring urinary tract infections

Diagnosis

The doctor will ask about the child’s symptoms and medical history. A physical exam will be done.

Images of the kidneys and urinary tract may be taken with:

• Ultrasound
• KUB (kidney, ureter, bladder) x-rays
• Spiral CT scan
• Rarely, IV pyelogram (IVP)

A 24-hour urine test may also be done to look for mineral levels in the urine such ascalcium, phosphorus, uric acid, oxalate, and citrate.

Treatment

The goal of treatment is to get rid of the kidney stone and ease symptoms. How this is done depends on the kidney stone's size and where it is. Treatment may include:

Water

For small kidney stones, having a child drink plenty of water will help the body pass the stone in the urine. A special cup may be provided to catch the stone when it passes so that it can be analyzed.

Children who are having a hard time keeping fluids down may need to go to the hospital to get fluids through an IV.

Medication

The doctor may give medicine to:

• Ease pain
• Dissolve or expel the kidney stone

Surgery

Surgery may be needed if the stone is:

• Very large or growing larger
• Causing bleeding or damage to the kidney
• Causing an infection
• Blocking the flow of urine
• Unable to pass on its own

Types of surgery include:

• Extracorporeal shock wave lithotripsy (ESWL)—uses shock waves to break up stones that are too large to pass
• Ureteroscopy and stone basketing or laser lithotripsy—a camera is used to find the stone
  • Stone basketing—A tiny basket is used to remove the stone.
  • Laser lithotripsy—The stone is broken into smaller pieces with a laser if it is too large to remove.

These surgeries are rarely done:

• Percutaneous nephrolithotomy—uses a scope placed through a small tube in the back to remove a large stone
• Lithotomy—open surgery to remove a stone

Prevention

Once a child has had one kidney stone, more stones are likely. To help reduce a child's chance of future stones:

• Have the child drink plenty of fluids, especially water. Avoid sodas.
• Make sure the child does not eat too much food that is high in salt, such as potato chips, french fries, or processed meats.
• A calcium-rich diet can help bind oxalate before it reaches the kidney. Encourage the child to have milk and yogurt.
• Work with their doctor to help find the safest way for the child lose weight, if needed.
• Encourage the child to drink water when they are being active, such as when they play sports.