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Kidney Stones in Children: What to Know

Kidney stones occur when high levels of certain minerals build up in the urine. Symptoms of kidney stones in children can include sharp pain in the lower abdomen, blood in the urine, and changes in toilet habits.Kidney stones may be more common in adults than in children. However, kidney stones can affect people of any age.

Kidney stones in children often link to an underlying condition, such as dehydration, cystic fibrosis, or urinary tract infections (UTI).

As a result, it is essential to contact a doctor for any symptoms of kidney stones in children. The doctor may need to check for underlying health conditions and provide treatment.

Read on to learn more about kidney stones in children, including their symptoms, causes, and treatment.

Types and causes

Kidney stones occur when chemical and mineral changes affect how the kidneys filter out waste products through the urine. If levels of specific waste products get too high, they can form the hard deposits that make up kidney stones.

Different types of kidney stones exist. They can vary in location, cause, and what they are made of. Types of kidney stones are:

  • Calcium stones: According to the National Institutes of Health (NIH), calcium stones are the most common type of kidney stone in children. They occur when the kidneys release too much calcium, which can build up with other waste products to form stones.
  • Uric acid stones: Uric acid stones form when the urine contains a high uric acid level. Uric acid levels may increase due to medical conditions. Less frequently, eating a diet high in seafood and meat can contribute to uric acid stones.
  • Struvite stones: Struvite stones develop due to a bacterial infection in the upper urinary tract. They may be more common in children whose urinary tracts developed atypically, causing the flow of urine to be blocked.
  • Cystine stones: Cystine stones develop due to a hereditary genetic condition called cystinuriaCystinuria causes the kidneys to leak cysteine, an amino acid. This can then build up to form stones.

Factors that may contribute to kidney stones in children include:

  • dehydration
  • a high intake of sugar or sodium
  • a diet that is high in protein and low in fiber
  • low levels of physical activity, such as during recovery from injury or surgery
  • kidney infection or UTI

Related conditions

Some conditions may increase the likelihood of kidney stones in children, including:

Certain medications may also increase the risk of kidney stones when taken long-term, such as:

  • diuretics
  • calcium-based antacids
  • too much vitamin D
  • some HIV medications, such as protease inhibitors
  • some seizure or migraine medications, such as topiramate (Eprontia, Qudexy XR) and zonisamide (Zonegran, Zonisade)

Ketogenic diets may also increase kidney stone risk.

Symptoms

Symptoms of kidney stones in children can include:

  • sharp or severe pain in the lower back or abdomen, sides, or groin
  • a persistent need to urinate
  • pain when urinating
  • difficulty passing urine or only passing a small amount
  • blood in the urine, which may appear pink, red, or brown
  • urine that is cloudy or has an unpleasant smell
  • irritability
  • nausea or vomiting
  • fever and chills

When to see a doctor

Contact a doctor or the child’s pediatrician promptly for any symptoms of kidney stones in children.

Some cases of kidney stones may require emergency care. Call 911 or your local emergency services for any of the following symptoms:

  • worsening or severe pain
  • inability to pass urine
  • blood in the urine
  • any other symptoms that feel severe or concerning

Kidney stones can be serious and may lead to complications without early or effective treatment.

Diagnosis

To diagnose a child’s condition, a doctor will first ask about their symptoms, medical history, and family medical history. They may also conduct a physical exam.

Further tests can help identify kidney stones and rule out other conditions. Tests may include:

  • urinalysis and urine cultures after giving a urine sample
  • 24-hour urine collection, which uses a urine collection container to store all urine passed over 24 hours
  • blood tests
  • imaging tests, such as:

Sometimes, a medical professional may request that the child urinate through a strainer for a few days in case small pieces of stone pass. These stones can be collected and given to your medical team to analyze in a laboratory and determine their type.

Treatment

Treatment can depend on the size and type of the kidney stone. Small kidney stones sometimes pass through the urine on their own. However, a child may also need to drink plenty of fluids to help the stones pass.

A doctor may provide medications to ease symptoms and help the stone pass. These might include thiazide diuretics, also known as water pills, and intravenous fluids that can help relieve dehydration, if needed.

Ask a doctor which over-the-counter pain relief medications may be appropriate for the child. Do not give aspirin to children under the age of 16 years unless their doctor approves it, as it can increase the risk of Reye syndrome.

A child may need surgery to remove large or painful kidney stones or stones that block the urinary tract.

Procedures to remove kidney stones can include:

  • Shock wave lithotripsy: This is a noninvasive procedure that uses shock waves to break up a kidney stone into small pieces that are easier to pass. The child’s medical team may give them anesthesia to avoid pain or help keep them still.
  • Cystoscopy and ureteroscopy: During this procedure, a clinician will insert a very thin tube with a small lens into the urethra to find a stone in the urinary system. The urethra is the tube through which urine leaves the body. They will then remove the stone or break it into smaller pieces. This is also done using anesthesia or sedation.
  • Percutaneous nephrolithotomy: To remove the kidney stone, a surgeon will make a small cut in the back to access the kidney and remove the stone or break it into small pieces.

Contact a doctor if you have questions about treatment for kidney stones.

Diet

Drinking enough fluids is one of the most important steps to help prevent and pass kidney stones. Fluid recommendations can vary per person, so you can talk with a doctor or a registered dietitian for tailored advice about daily fluid intake.

Research also suggests that a Dietary Approaches to Stop Hypertension (DASH) diet may help prevent kidney stones. Read more about the DASH diet, including which foods to add or limit.

That said, the best diet can depend on the type of kidney stone and the child’s underlying health. For example, if the child has uric acid stones, it may help to limit animal protein sources and prioritize vegetable proteins, such as legumes, soy, and nuts.

Contact a doctor or registered dietitian for advice on a child’s diet and what foods to include or avoid.

Learn more about diets for kidney stone treatment and prevention.

Prevention

Not all kidney stones can be prevented.

However, drinking enough liquid, based on a doctor’s recommendation, can help reduce the risks of kidney stones in children. A doctor may also prescribe preventive medications depending on the stone type the child has previously experienced, such as:

  • For struvite stones: antibiotics
  • For calcium stones: potassium citrate to increase citrate levels in the urine as well as thiazide diuretics
  • For uric acid stones: allopurinol, which can help decrease uric acid levels
  • For cystine stones: D-penicillamine or tiopronin to help dissolve cystine in the urine

Summary

Kidney stones in children may cause symptoms, such as severe abdominal or back painnausea, and difficulty passing urine. Children may also experience other changes in their urine, such as passing urine less often or passing bloody or cloudy urine.

Causes of kidney stones can include a diet high in sodium and sugar, dehydration, and underlying conditions such as cystic fibrosis and infection.

Treatment for kidney stones can include medications to help reduce symptoms and help the child pass the stones through the urine. Larger stones may require surgical removal.


https://www.healthgrades.com/right-care/kidneys-and-the-urinary-system/kidney-stones-in-children

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