Why Are Kidney Stones Dangerous in Children?

During the 1970s and 1980s, doctors and pediatricians used to treat kidney stones in children once every few months. In recent years, kidney stones in children have increased dramatically, with some hospitals creating clinics dedicated to pediatric kidney stones. Left untreated, kidney stones can cause children permanent kidney damage, block urine flow and possibly lead to kidney failure.

Symptoms

• Kidney stones, also known as nephrolithiasis or urolithiasis, develop in children when minerals and substances such as calcium, uric acid, cystine and oxalate accumulate in the bladder, ureter or kidneys, creating crystal-like stones. The most common symptoms of kidney stones in children include blood in the urine, extreme waves of pain also known as renal colic, nausea and vomiting, frequent urgency to urinate, abdominal pain and back pain. Younger children might not show noticeable symptoms of a kidney stone and are diagnosed during imaging testing for other medical reasons.

Treatment

• Children who have small kidney stones 5mm or smaller will often be able to pass the stones at home. Your pediatrician might recommend nonsteroidal anti-inflammatory medications to manage pain as well as require increased fluid intake to flush the stone from the ureter, bladder or kidneys. Children who have larger kidney stones might need to undergo shock wave lithotripsy or percutaneous nephrolithotomy to remove the stones. Shock wave lithotripsy uses high-energy shock waves to break the stone into smaller fragments that are easily passed. Percutaneous nephrolithotomy involves small telescopic instruments that are inserted into the skin to remove the stones. Shock wave lithotripsy can be used in conjunction with percutaneous nephrolithotomy to create smaller stones for removal. Ureteroscopy is another option for removal that involves the insertion of small telescopic instruments into the urethra, bladder, ureter and then kidney to remove stones. Ureteroscopy telescopes contain cameras that allow doctors to view the obstructing stones.

Prevention/Solution

• Children who have had kidney stones have a 30 percent to 65 percent chance of developing stones again. In order to decrease the chances that the stones will develop again, preventative measures such as routine blood and urine testing for metabolic disorders and increased fluid intake should be strictly adhered to. Children under 5 should drink at least four cups of water a day, while children between the ages of 5 and 10 should drink six cups of water a day. Children older than age of 10 need to consume at least eight cups of water daily. Increased fluid intake will result in increased urine flow through the bladder and kidneys, preventing the build-up of minerals and creation of kidney stones.

Considerations

• If your child had excessive stones during the first episode and carries metabolic risk factors, your pediatrician might want to monitor your child to prevent new stones from developing. To monitor your child for kidney stones, your pediatrician will likely perform imaging tests, such as an ultrasound, to view any developing abnormalities.

Warning

• Children who have had kidney stones and have increased levels of calcium in their urine, also known as hypercalciuria, will need to follow rigid dietary guidelines in addition to increased fluid intake. Children with hypercalciuria need to eat a low-sodium diet, eat potassium-rich foods such as fruits and vegetables, and avoid vitamin D and calcium supplements. If hypercalciuria continues to be a problem, your child might need to take medication to decrease calcium levels.