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Comprehensive Stone Center

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Kidney stones are becoming more common in children. In addition, some children have genetic conditions that cause kidney stones or have other conditions that lead to kidney stones.

The diagnosis and management of stone disease in children can be complex. The Children’s Health Comprehensive Stone Center, a program in the Pediatric Urology Department, is dedicated to the management of stone disease in children. Here, pediatric urologists work closely with pediatric nephrologists and dieticians to ensure that children receive the very best stone treatment and prevention in a coordinated and convenient program. Our experience allows us to provide the most complete medical, surgical and nutritional guidance for the diagnosis, treatment and prevention of kidney stones in children.

What to Expect

At your child’s visit, a history and physical examination will be performed and all prior tests will be reviewed. Additional blood and urine tests may be needed as well as additional radiologic imaging. We also provide thorough education to you and your child to make sure you understand why stones can happen and the best ways to deal with and prevent more. A follow-up plan and any referrals to other specialists will be made during the visit.

If surgery is necessary, this will be discussed and can be scheduled immediately after the visit.

Our center is also dedicated to discovering the cause of kidney stones and ways to prevent them. Therefore, if you and your child are interested, you may be asked to be involved in research studies.

Diagnostic Tests

A kidney stone or ureteral stone can usually be diagnosed using one or more tests or procedures, including:

Imaging tests such as an ultrasound of the kidney, an X-ray of the abdomen, or by a CT scan of the abdomen and pelvis.

Blood tests to determine the levels of chemicals in the system that might be contributing to stone formation, or certain hormone levels related to calcium metabolism.

Urine tests including a 24-hour urine collection to evaluate how much urine is being made and what some of the chemicals are in the urine. Results help determine the cause of the kidney stone and ways to prevent future stones.

Analysis of kidney stones that are passed or surgically removed. These stones are sent to the lab for analysis to determine the makeup of the stone and help the doctor understand what is causing stones to form and how to prevent more stones. Your doctor will show you how your child can urinate in a special strainer to catch stones that are passed.

Treatment & Prevention

Treatment for kidney stones is dependent upon the type of stone, its cause and how it affects your child.

Treating symptoms

If the kidney stone has gone into the ureter and is causing your child pain and nausea, your doctor can prescribe medication to reduce the symptoms. Medication may also be prescribed to help your child pass the stone. Your doctor will show you how your child can urinate in a special strainer to catch stones that are passed.

If the stone is too large, does not pass within a reasonable amount of time, is in the kidney but increasing in size over time, causes persistent symptoms or is causing fever and possible infection, a surgery may be needed to remove the stone. Types of surgeries performed by pediatric urologists at Children’s Health include:

Ureteroscopy with laser lithotripsy is a procedure that allows the surgeon to see inside the bladder and ureter and then, by using a small laser, break up the stone into small pieces that can be passed during urination.

Extra-corporeal shock wave lithotripsy (ESWL) is the use of high-energy sound waves to break up the stone into small pieces that can be passed during urination.

Percutaneous nephrolithotomy is a surgical procure that requires a small incision into the kidney. A tube is inserted and the surgeon is able to locate and then remove the stone through the tube.

The procedures will be discussed in more detail at your clinic visit. Sometimes a temporary drainage stent needs to be placed before or after the surgery.

Preventing Reoccurrence

Once results from the stone analysis and any blood or urine tests are obtained, the goal will be to prevent future stones. A thorough history and physical exam will help identify any medical conditions, medications or prior surgeries that increase your child’s risk of kidney stone formation. The pediatric urologists and nephrologists will then be able to provide specific recommendations to help prevent the reoccurrence of kidney stones. Those recommendations may include:

  • Increasing fluid intake
  • Decreasing salt intake
  • Dietary changes
  • Medication

FAQs

What is a kidney stone?

A kidney stone is a solid piece of material that forms in a kidney. Kidney stones vary in size. Some can pass out of the body causing little or no pain. A larger stone may get stuck along the urinary tract and can block the flow of urine, causing severe pain.

 

What causes kidney stones?

A kidney stone forms when substances in the urine become highly concentrated. The causes can include a blockage in the urinary tract, a genetic tendency, drinking too little water or eating too much salt, a bacterial infection in the urinary tract, or a condition that prohibits the body from effective digesting food.

Is there a way to prevent kidney stones from forming?

Children should drink plenty of water. Water helps keep the urine diluted and flush away substances that could form kidney stones.

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