Most people think of kidney stones as an adults-only condition, but anyone can get them, and that means children too.
A kidney stone is a pebbly substance that forms in a child’s kidney if the urine mineral level is too high. Kidney stones must be treated by a health care professional.
Craig Andrew Peters, M.D., pediatric urologist at Children’s Health℠ says a family history of stones increases the chance of developing them. “Kidney stones are not uncommon and affect one in ten people,” Dr. Peters says. “When materials build up and don’t dissolve in the urine, solid crystals, that form stones, can develop. Kidney stones contain minerals like calcium.”
Kidney stone symptoms
Small kidney stones can pass through the urinary tract without causing any symptoms. If your child has larger stones he or she may experience:
- Sharp pain in the back, side, lower abdomen or groin
- Blood in urine
Diagnosing your child
Your pediatrician or pediatric urologist evaluates your child’s symptoms and medical history, conducts a physical exam, and orders tests to diagnose a kidney stone and find out what may have caused it.
Dr. Peters says, “Imaging tests tell us the size, location and amount of stones your child has. An abdominal X-ray can pinpoint a stone in the kidneys or ureters. A renal bladder ultrasound (RBUS) helps us find a stone and signs of blockage. If these tests don’t tell us the information we need, we can perform an abdominal/pelvic CT scan.”
Treating your child
Stones may pass if your child drinks extra fluids. Medical Expulsive Therapy (MET) is a technique in which your physician prescribes a medicine like Tamsulosin to increase the chances of passing a stone. If your child is in a lot of pain or if the stone is large, it may have to be removed or broken up into smaller pieces. Surgery is necessary when:
- The stone doesn’t pass within 15 days, a fever develops or there is constant pain
- The stone is too large to pass naturally
- Urine flow is blocked
- There is an ongoing urinary tract infection
- There is constant bleeding or kidney damage
- A follow-up X-ray reveals the stone has become larger
Procedures to break up kidney stones include:
- Extracorporeal Lithotripsy. This procedure takes place in an outpatient setting and uses an instrument to break the stone into small bits that can pass naturally. This procedure does not involve inserting any instruments into the body, but depends on focusing a shock wave at the stone.
- Percutaneous nephrostolithotomy (PCNL). This procedure uses a needle inserted through the skin into the kidney, and special surgical instruments to remove kidney stones. Hospitalization is required and recovery is generally within two weeks.
- Ureteroscopy. In this procedure, a fiberoptic telescope (ureteroscope) passes through the urethra and bladder to the stone. It removes or breaks up stones using a laser. It is performed in an outpatient setting.
Dr. Peters says, “At Children’s Health Comprehensive Stone Center, treatment options include advanced procedures including robotic-assisted surgery (laparoscopy) and minimally-invasive techniques (MIS) to speed your child’s recovery.”
Risk and prevention
In addition to your family’s medical history, risk factors include:
- Dehydration. If your child doesn’t drink enough during the day, there is less fluid available to dissolve any crystals in the urine. This is particularly important in warm-weather areas like Texas.
- Diet. Too much animal protein, salt or oxalates (found in leafy greens, tea, nuts like almonds, cashews and peanuts, or chocolate) can cause mineral imbalances that increase the chances for stones to form.
Dr. Peters says, “It may sound surprising but, yes, too much spinach can be too much of a good thing. When it comes to kidney stones, good hydration and a balanced diet that is not based on too much of one thing is a great way to prevent kidney stones.”
If your child may need treatment for kidney stones, speak to your Children’s Health pediatrician for more advice.
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