Kidney stones have become more common in kids and teenagers in the last 20 years. They can affect kids of all ages, including premature babies, but the majority of stones appear in teenagers. These stones occur when minerals concentrate in the kidneys. Children who have suffered from a kidney stone are at an increased risk of getting another, a condition known as “recurrence”. After one kidney stone occurrence, children had a 16% to 44% chance of recurrence. The frequency of kidney stones in pediatric departments has increased in the previous decade, from 5-10% to 20-25%, and understanding the symptoms, causes, and treatments can aid in managing and avoiding kidney stones in kids. Kidney stones among children can cause considerable pain.
Kidney stones occur when minerals form inside the kidneys. Then they grow and become kidney stones. It’s possible for kidney stones to enter the urine tract. They can cause pain and blood in the urine (pee). Some stones may hinder the passage of urine. Most kidney stones move through the body without causing any damage. Stones usually form in the kidney or the ureter, which links the kidney to the bladder. They rarely develop in the bladder. Kidney stone symptoms in children and teenagers vary depending on the size and location of the stone.
What are Kidney Stones?
Kidney stones are hard deposits in the kidneys when certain substances, such as calcium, oxalate, and uric acid, become highly concentrated in the urine. These deposits can range in size from a grain of sand to larger, pebble-like structures.
Types of Kidney Stones
Calcium Stones
They are commonly occurring kidney stones, usually consisting of calcium phosphate or calcium oxalate. These stones form when calcium in the urine combines with oxalate, a substance in many foods. When there’s too much oxalate or less liquid in the urine, crystals can form and eventually develop into stones. Calcium-based stones constitute about 80% of the kidney stones.
Uric Acid Stones
They are formed due to large amounts of 7,9-Dihydro-1H-purine-2,6,8(3H)-trione(uric acid)in the urine, often linked to high-protein diet substances found in certain foods like meat, fish, and some alcoholic beverages or specific medical conditions. Uric acid-based stones constitute about 5%-10% of kidney stones.
Struvite Stones
They are called infection stones made of magnesium ammonium phosphate. They typically develop due to infection in the urinary tract (UTIs), caused by ammonia-producing bacteria that make the urine more alkaline. Struvite-based stones constitute about 10% of kidney stones.
Cystine Stones
A specific kind of kidney stone develops when a surplus of amino acid cystine accumulates in our urine. This condition is known as cystinuria, an uncommon genetic condition. Chances for cystine stones to occur are less than 1%.
How big are kidney stones?
Kidney stones differ in size, with most measuring between 3mm to 6mm. It is beneficial to gather any stones your child passes while urinating so your doctor may send them for laboratory analysis. Knowing exactly what the stone is made up of can help the doctor treating your child find strategies to prevent further stones from forming.
Kidney stones risk factors in children.
- There are numerous risk factors for developing kidney stones. Here are a few common examples:
- Family genetics aid in stone formation.
- Food high in salt content, red meat, and junk food, but lacking fruit and vegetable intake.
- Not drinking ample water which leads to low urine output.
Other types of risks include:
- Conditions that are inherited such as hyperoxaluria and cystinuria.
- Medications are used for seizures or blood pressure which in turn removes fluids from the body.
- The blockage is caused by the flow of urine.
- Any kidney infection.
- Bowel disease
- Having had surgery to lose weight.
- Insufficient physical exercise such as wearing a cast following surgery, can cause calcium to leave the bones, accumulate in the urinary tract, and contribute to stone development.
Signs and symptoms of kidney stones in children
Kids suffering from kidney stones can have varying symptoms purely depending on the stone’s location, size and if they block the passage of urine. Some of the prominent symptoms can be:
1. Pain
- Unbearable pain around the abdomen, flank and backside. The most noticeable symptom is that the pain occurs periodically and varies in intensity (renal colic).
- When kidney stones in kids are present in the lower ureter, they experience pain in the groin area and abdomen.
2. Blood in your pee (urine) – Hematuria
- Pink, brown or red-colored urine where blood is visible easily.
- Blood that is not detectable by the eye but can be detected in urinalysis. This is known as microscopic Hematuria.
3. Urinary Symptoms
- Feeling the need to urinate constantly.
- Painful and burning sensation known as dysuria during urination.
- Less urine output due to the presence of a possible blockage
4. Nausea and Vomiting
- Such signs and symptoms are common due to the body’s response to pain when urine is blocked.
5. Fever and Chills
- When kidney stones induce blockage, there may be fever and chills owing to pain. This could potentially be an indication of urinary tract infection (UTI).
6. Restlessness and Irritability
- Younger children may not recognize the symptoms and may appear fussy and irritated.
7. Urine Changes
- Cloudy and/or bad-smelling urine.
- Presence of stony particles in urine.
8. General Discomfort
- Non-specific symptoms include weariness or general weakness, especially with younger children.
When to get Medical Attention:
- When severe pain is persistent in the lower back, flank, abdomen or groin area.
- When children have fever & chills with significant discomfort.
- Visible blood in the urine.
- Difficulty during urination or complete inability to urinate.
Early detection and treatment are essential for averting problems such as renal damage or recurring infections. If you suspect kidney stones in a child, consult a urologist immediately.
How are kidney stones diagnosed in children?
The doctor will enquire about your symptoms, how long they have been present, your diet, and whether you are dehydrated. If there is a history of kidney stones in the family or urinary or renal difficulties, then request that you undergo any of the following tests as mentioned below
- Blood tests
- Urine tests
- Kidney function tests
- Imaging tests, such as ultrasounds, X-rays, or CT scans.
When an X-ray, ultrasound, or computed tomography (CT) scan reveals a stone in a child’s urinary tract, the diagnosis of kidney stones is typically confirmed.
An ultrasound is the preferred test for children who may have a stone. This is because ultrasounds are simple to perform, can identify most stones, and do not involve radiation. A CT scan can detect small kidney stones, but because this test exposes children to radiation, many urologists will first perform an ultrasound. They will then arrange a CT scan only if a stone is suspected but not detected by ultrasound.
Treatment for kidney stones in children
Kidney stones in infants and teenagers are treated based on size, nature, and symptoms. Some of the most effective kidney stone treatment options in children are:
1. Hydration and Pain Management
Increased Fluid Intake: One of the easiest and most effective therapies for kidney stones is keeping the youngster hydrated. Drinking plenty of water dissolves the chemicals in urine that might form stones, allowing them to flow through the urinary tract and be flushed out of the body. Parents should urge their children to drink ample water every day to produce clear or light yellow urine.
Pain Management
Managing the discomfort caused by kidney stones is critical, especially for children who may be particularly distressed. Pain medicines like ibuprofen and acetaminophen can help with mild to moderate pain. For more severe discomfort, doctors may give stronger pain medications to keep the youngster comfortable as the stones pass.
2. Medications
Alpha Blockers: Medications such as tamsulosin can be prescribed to help relax the muscles in the urinary tract, making it easier for the stones to pass. Alpha-blockers are used to treat stones that are stuck in the ureter, the tube that connects the kidney to the bladder.
Potassium Citrate: This drug is beneficial in avoiding the production of new stones, particularly in children with a history of calcium-based stones or who are following a ketogenic diet. Potassium citrate reduces the pH level of the urine, which helps to prevent kidney stone formation.
3. Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL employs shock waves to shatter kidney stones into tiny fragments, allowing them to pass naturally without surgery. The surgery is carried out under sedation or anaesthesia to keep the youngster comfortable throughout.
ESWL has a high success rate, with over 90% efficacy in treating renal and ureteral stones in children. It is the ideal procedure for treating stones that are too large to pass on their own but not big enough to necessitate more invasive surgery.
4. Ureteroscopy
Ureteroscopy is a treatment that involves inserting a slender, flexible scope known as a ureteroscope into the urethra and bladder to find and cure kidney stones. Once discovered, the stone can be removed or broken down into tiny pieces with a laser or other equipment.
• Holmium Laser Lithotripsy: breaks stones into small fragments, making them simpler to pass in urine. It is noted for faster operations and greater results than other approaches.
• Pneumatic Lithotripter: During ureteroscopy, stones are broken into smaller pieces using mechanical energy. This procedure effectively fragments kidney stones, allowing them to be easily passed in the urine.
5. Percutaneous Nephrolithotomy (PCNL)
PCNL is a surgery performed to remove large kidney stones. During the surgery, a tiny cut is made from the back and instruments are put directly into the kidney to extract the stones. PCNL is designated for very large stones that are difficult to remove using other means. It is extremely effective, but more invasive than other treatments.
6. Dietary Changes
Increased Hydration: Encouraging youngsters to drink more water is an effective preventive approach. Adequate hydration helps to dilute urine and avoid stone development.
Dietary Adjustments: Certain dietary adjustments can lower the risk of kidney stones. Limiting your intake of salt and oxalate-rich foods like spinach, chocolate, and nuts can be beneficial.
Preventive Measures
Kidney stones in children and teenagers can be prevented by making lifestyle and dietary modifications. Here are some important preventative measures:
• Encouraging children and teens to drink plenty of fluids is crucial. Aim to give them enough water so that their urine is clear or light yellow. To prevent kidney stones, stays hydrated and eat a well-balanced diet. Reduce your intake of salty and oxalate-rich foods, such as spinach, chocolate, and nuts. Encourage a rich diet of fruits and vegetables to help reduce the chance of stone formation.
• Regular medical check-ups help monitor and control health issues that may cause kidney stones. Conditions like hyperparathyroidism or urinary tract infections should be managed properly to reduce the risk.
Conclusion
Kidney stones in children and adolescents can be excruciatingly painful, but with the right understanding and care, symptoms can be treated and future stones avoided. If you suspect your child has kidney stones, seek medical attention immediately to determine the best treatment choices. Visit our website for more information on Urosonic’s kidney stone removal operation in Bengaluru.
We provide a variety of minimally invasive and non-invasive kidney stone treatment techniques that carry low risks and allow children to recover rapidly. You can speak with our Urologist to obtain a better idea of the type of treatment that is best for your child’s situation. To get started, visit our website and request an appointment.