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Kidney Stones in Children

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Kidney stones are formed due to the deposition of minerals in the urinary system. As a result, they block the urine flow. Read the article to learn more.

Medically reviewed by

Dr. Bhaisara Baraturam Bhagrati

Published At November 23, 2022
Reviewed AtNovember 24, 2022

Introduction:

The kidneys are important organs of the urinary system and carry out several functions. They filter the blood, form urine, expel the waste products from the body and maintain optimum fluid balance. Under normal conditions, the urine flows out of the body through the kidneys, ureters, urinary bladder, and urethra. However, the urine flow gets blocked in the presence of stones, tumors, and narrow ureters. Kidney stones are of varying sizes, and they can be as small as a grain or as large as the actual stones that we see in our daily lives. These stones might not cause a problematic situation if they pass out of the urine freely, but if they are large, they might get stuck and hinder the flow of urine.

Do Kidney Stones Occur in Children?

Kidney stones rarely occur in children. However, in the last twenty years, the number of children getting affected by kidney stones has increased. The condition can affect children of all ages, including newborns and teenagers. The causes of kidney stones in children include changing lifestyles, consuming excessive amounts of salty foods, snacks, and canned juices, and excessive body weight (obesity). Kidney stones form when minerals, salts, and crystals accumulate and form a mass. The substances which form stones in the kidney are calcium, oxalate, and uric acid. These come under crystal-forming substances; they remain undissolved and get separated from the urine. Therefore, if a child presents with symptoms of pain, hematuria (presence of blood in the urine), fever and vomiting, affected withit might indicate a kidney stone. Therefore, the parents need to consult the doctor immediately.

When Is the Child More Likely to Develop a Kidney Stone?

Kidney stones occur commonly in teenagers, but a child suffering from the following conditions is always at risk of developing stones:

  1. Urinary Tract Obstruction - If a child is born with an abnormality in the urinary tract that blocks the urine flow, the minerals and salts in the urine clump together and form stones.

  2. Inflammatory Bowel Disease - If a child suffers from bowel diseases, oxalates (stone-forming substances) are released in large amounts. These oxalates get absorbed in the kidneys and form stones.

  3. Cystic Fibrosis - It is a hereditary disease that damages the lungs, digestive system, and other body organs. Children suffering from cystic fibrosis lose a lot of oxalates in their urine. It is because they are not absorbed within the body. As a result, the oxalates accumulate in the kidneys and form stones.

  4. Hypercalciuria - In this condition, calcium is present in very high amounts in the urine, so the child is most likely to develop calcium stones.

  5. Hyperparathyroidism - The activity of the parathyroid glands increases, and they release excess calcium into the blood. As a result, the levels of calcium rise in the urine resulting in the formation of calcium stones.

  6. Urinary Tract Infections - If the urinary tract infection is left untreated for a long, the urine flow becomes restricted. As a result, the minerals and salts in the urine cluster up and form stones.

  7. Medications - Certain medications increase the risk of kidney stones, particularly calcium stones. These drugs inhibit the reabsorption of the stone-forming minerals from the urine. As a result, the levels of sodium and calcium increase resulting in the formation of stones. The medications that can increase calcium and sodium levels are listed below:

    • Furosemide.
    • Bumetanide.
    • Calcium Carbonate (calcium-based antacids).
    • Cholecalciferol (vitamin D tablets).
    • Topiramate.
    • Indinavir.

What Are the Causes of Kidney Stones in Children?

The causes of kidney stones in children are listed below:

  • Nutrition and Diet - The diet has an impact on kidney stones. Foods like chocolates, beets, and rhubarb contain oxalates that increase the risk of stones.

  • Bone Fractures - If bone fractures occur in children, a plaster cast is put around the area to keep it immobile. When the child cannot move, bones release calcium into the blood, increasing the risk of calcium stones.

What Are Some of the Different Types of Stones in Children?

The different types of stones in children are described in the table below:

Types of Kidney Stones Description

What Are Some of the Signs and Symptoms of Kidney Stones in Children?

Kidney stones do not produce any symptoms if they are small and pass through the urine. If the stones are large, the following symptoms are usually noted:

  1. Presence of sharp pain in the lower back and abdominal region.

  2. The urine appears pink or red due to the presence of blood (hematuria).

  3. The child experiences pain while passing urine.

  4. There is a strong and constant urge to urinate.

  5. The urine flow becomes restricted, so the patient can pass only a few drops of urine each time.

  6. The urine smells bad.

  7. Pain is accompanied by fever and nausea in children.

How Are Kidney Stones in Children Diagnosed?

Kidney stones are diagnosed based on medical history, laboratory, and imaging tests. The medical history gives an idea about the symptoms of the condition, the time of their onset, and other conditions the child is suffering from. Imaging tests and laboratory tests help to confirm the diagnosis. The methods of diagnosis are listed below:

Laboratory Tests: The following laboratory tests are done on children:

  • Urinalysis - The child collects the urine in a container in this test. A tube known as a catheter is inserted to collect urine in babies. Urinalysis helps detect the urine's minerals, blood, bacteria, and white blood cells. Kidney disease can be suspected if any of these is in excess.

  • Blood Tests - The doctor recommends a blood test to check the health of the kidneys and if any infection is present in the body.

Imaging Tests: The following imaging tests are done to diagnose kidney stones:

  1. Ultrasound - It is an imaging test done in children to detect the presence of stones. The advantage of the procedure is that the child is not exposed to X-rays. The child is laid down on a table during the procedure, and the doctor moves the ultrasound probe over the abdomen. As a result, the sound waves reach the body, and the urinary system images are obtained on the computer screen.

  2. Abdominal X-ray - In this procedure, an X-ray machine is placed close to the abdomen of the child to record the images of the urinary system. As a result, the images are obtained on the computer screen, enabling the doctor to detect kidney stones.

  3. Computed Tomography (CT scans) - In this technique, the child is laid down on a table that slides into a tunnel-like device where the X-rays are taken. The images provide a clear view of the internal organs, especially the kidneys, and help identify stones. The disadvantage of the procedure is that the child is exposed to a lot of radiation.

How Are Kidney Stones Treated in Children?

The following treatments are required to be done if the stones are large and restrict the urine flow:

  • Lithotripsy - It is a procedure in which shock waves are sent to the body to break the stone into pieces. First, the stone is located with the help of an X-ray. The high-energy shock waves are then directed toward the stone to break it into pieces allowing them to pass through the urine.

  • Ureteroscopy - A small tube known as the ureteroscope is inserted through the urethra to examine the urinary tract. If a stone is present, it is directly removed or broken down by passing surgical instruments through the ureteroscope.

  • Percutaneous Nephrolithotomy - This procedure is carried out under general anesthesia meaning the child is put to sleep. First, an incision is made in the lower back to insert a tube known as a nephroscope. It helps the doctor to locate as well as remove the stone. If the stone is large, it is broken into smaller pieces and allowed to pass through the urine. After the procedure is complete, a tube known as a ureteral stent is inserted and left for a few days to facilitate the passage of urine.

How to Prevent Kidney Stones in Children?

Kidney stones can be prevented in children in the following ways:

  1. The child needs to drink a sufficient quantity of water daily to maintain optimum fluid balance and flush out the bacteria from the body. Teenagers who experienced the problem of kidney stones in the past need to drink at least eight glasses of water daily.

  2. Citrus fruits like oranges, grapes, and lemons should be consumed daily because these fruits contain citrate that inhibits stone formation.

  3. After the child has been diagnosed with kidney stones, potassium citrate tablets are usually recommended to increase the citrate levels in urine.

  4. Salty food items, animal foods like chicken, meat, and fish, and food rich in oxalates like nuts, chocolates, and rhubarbs should be avoided to balance the sodium, calcium, and oxalate levels.

What Are Some of the Complications of Kidney Stones in Children?

If left untreated for long, kidney stones interfere with urine flow. As a result, the urine remains within the body for a long time and increases pressure on the kidneys resulting in a condition called hydronephrosis. The kidneys swell and fail to carry out their activities. The risk of urinary tract infection also increases as the bacteria grow rapidly in the urine. The patient presents with symptoms of pain, hematuria (blood in urine), and a burning sensation while passing urine in urinary tract infections.

Conclusion:

Kidney stones form when minerals and salts are present in excess urine. The presence of stones does not allow the urine to flow freely. As a result, the child experiences difficulty in passing urine along with pain. If the stone remains in the urinary system for a long time, the kidneys become permanently damaged. The parents need to note the symptoms and consult the doctor immediately to prevent further damage. Along with surgical treatments, the parents must encourage the child to drink plenty of water and maintain healthy bladder habits to prevent stones. If kidney stones are diagnosed and treated early, complications rarely occur, and the child lives a healthy life ahead.

Frequently Asked Questions

1.

What Are Some of the Signs of Kidney Stones in Children?

Kidney stones do not produce symptoms if they are small and pass through the urine. If the stones are large, the following symptoms are usually noted:
- Presence of sharp pain in the lower back and abdominal region.
- The urine appears pink or red due to the presence of blood (hematuria).

2.

Why Would a Child Have a Kidney Stone?

The causes of kidney stones in children include changing lifestyles, consuming excessive amounts of salty foods, snacks, and canned juices, and excessive body weight (obesity). Kidney stones form when minerals, salts, and crystals accumulate and form a mass. The substances which form stones in the kidney are calcium, oxalate, and uric acid.

3.

How Are Kidney Stones Treated in Children?

The following treatments are required to be done if the stones are large and restrict the urine flow:
- Lithotripsy is a procedure in which shock waves are sent to the body to break the stone into pieces. 
- Ureteroscopy - A small tube known as the ureteroscope is inserted through the urethra to examine the urinary tract.
- Percutaneous Nephrolithotomy - This procedure is carried out under general anesthesia meaning the child is put to sleep.

4.

What Are the Causes of Kidney Stones in Children?

The causes of kidney stones in children are listed below:
- Nutrition and Diet - The diet has an impact on kidney stones. Foods like chocolates, beets, and rhubarb contain oxalates that increase the risk of stones.
- Bone Fractures - If bone fractures occur in children, a plaster cast is put around the area to keep it immobile. When the child cannot move, bones release calcium into the blood, increasing the risk of calcium stones.

5.

Will the X-Ray Show Kidney Stones?

Kidney stones are diagnosed based on medical history, laboratory, and imaging tests. For example, in an abdominal X-ray, an X-ray machine is placed close to the child's abdomen to record the images of the urinary system. As a result, the images are obtained on the computer screen, enabling the doctor to detect kidney stones.

6.

Does Ultrasound Detect Kidney Stones in Children?

Ultrasound is an imaging test done in children to detect the presence of stones. The child is laid on a table during the procedure, and the doctor moves the ultrasound probe over the abdomen. The sound waves reach the body, and the urinary system images are obtained on the computer screen.

7.

What Are the Tests Done to Detect Kidney Stones?

Laboratory Tests: The following laboratory tests are done on children:
- Urinalysis - The child collects the urine in a container in this test. A tube known as a catheter is inserted to collect urine in babies. Urinalysis helps detect the urine's minerals, blood, bacteria, and white blood cells. Kidney disease can be suspected if any of these is in excess.
- Blood Tests - The doctor recommends a blood test to check the health of the kidneys and if any infection is present in the body.

8.

What Are Some of the Complications of Kidney Stones in Children?

If left untreated for long, kidney stones interfere with urine flow. As a result, the urine remains within the body for a long time and increases pressure on the kidneys resulting in a condition called hydronephrosis. As a result, the kidneys swell and fail to carry out their activities.

9.

How to Prevent Kidney Stones in Children?

Kidney stones can be prevented in children in the following ways:
- First, the child needs to drink sufficient water daily to maintain optimum fluid balance and flush out the bacteria from the body. Teenagers who experienced the problem of kidney stones in the past need to drink at least eight glasses of water daily.
- Citrus fruits like oranges, grapes, and lemons should be consumed daily because these fruits contain citrate that inhibits stone formation.
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Dr. Bhaisara Baraturam Bhagrati
Dr. Bhaisara Baraturam Bhagrati

Pediatrics

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