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 can form around bacteria
• Inherited abnormality in the way the body handles cystine
• Foreign bodies in the urinary tract, such as stents or catheters
• Abnormal function of the urinary tract, such as neurogenic bladder

Risk Factors

Factors that may increase your child’s chance of developing kidney stones include:

• Dehydration —not drinking enough fluids
• Eating foods high in salt
• Eating a ketogenic diet to help control epilepsy
• Mineral content of water your child drinks (hardness or softness of the water)
• Having family members who have had kidney stones or gout
• Having kidney stones in the past
• Being overweight
• Medical conditions, such as urinary tract infections or metabolic conditions
• Geographic location—residents of the Southeast United States have an increased risk
• Limited physical activity
• Foreign material in the urinary tract, such as a catheter

Symptoms

Occasionally, kidney stones do not cause symptoms, and they leave the body in the urine. Often a kidney stone can cause symptoms such as:

• 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

You will be asked about your 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 levels of minerals in the urine including calcium , phosphorus , uric acid, oxalate, and citrate.

Treatment

Treatment depends on the size and location of the kidney stone. Treatment may include:

Water

For small kidney stones, having your 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. If your child is having a hard time keeping fluids down, hospitalization may be needed to receive fluids through an IV.

Medication

Your child may be advised to take:

• Over-the-counter pain relievers
• Prescription pain relievers
• Medication to 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 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—camera is used to locate 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.

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

Prevention

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

• Have your child drink plenty of fluids, especially water. Avoid sodas.
• Make sure your 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 milk and yogurt.
• If your child is overweight, work with your child’s doctor to learn the safest way for your child to lose weight.
• Encourage water during sporting activities or other active playtimes.