Kidney stones were once thought of as an adult diagnosis. The truth is that kidney stones in the pediatric population have been on the rise for the past few decades. Our Division of Urology used to treat just a handful of children with kidney stones a year, but today we are diagnosing, managing and treating children with kidney stones daily. Each year, our Stone Center treats nearly 300 patients with kidney stones.
Diet, genetics and life-style can all play a lead role in the development of kidney stones. Many families are unfamiliar and uncomfortable with their child’s diagnosis of a kidney stone. We are committed to educating families about the diagnosis and tailoring a management plan specific to each patient. We have an experienced surgical staff and a state-of-art approach using minimally invasive surgery (MIS) whenever surgical intervention is needed. Our outpatient management team helps families manage active stone disease and prevent stone recurrence.
Normally, urine contains many dissolved materials. At times, some materials may become concentrated in the urine and form solid crystals. These crystals can lead to the development of stones. Most stones contain calcium, specifically, calcium oxalate. Other types of stones contain things such as calcium phosphate, uric acid, cystine and struvite.
Several risk factors play major roles in stone formation:
Once stones form in the urinary tract, they often grow over time and may move within the kidney. Some stones may be washed out of the kidney by urine flow and end up trapped within the ureter. Stones usually begin causing symptoms when they block the outflow of the urine to the bladder.
Symptoms of an obstructing stone can vary. Most often, patients will complain of pain in their sides (flank). This pain may also move toward the front of the abdomen or to the groin area.
A simple X-ray of the abdomen is sometimes enough to pinpoint a stone in the area of the kidneys or ureters. A renal bladder ultrasound (RBUS) may be ordered to help find a stone and look for any signs of blockage. If the X-ray film or RBUS does not provide enough information to make a diagnosis, an abdominal/pelvic CT scan will be done. This test can detect almost all types of urinary stones.
These tests give your urologist information about the size, location and number of stones that are causing the symptoms. This allows your physician to choose the best treatments.
To choose the best treatment for your child, your doctor will consider the size of the stone, the number of stones and their location. Most small stones can pass on their own. We may ask your child to ‘strain’ his urine with a special filter so we can send the stone for testing, if necessary, to determine what kind of stone it is.
Surgery may be needed if a stone:
Although each person is different, there is about a 50 percent chance of having another stone within the next five years. Your child may be asked to collect urine for 24 hours after a stone has passed or been removed to measure urine volume and levels of acidity, calcium, sodium, uric acid, oxalate, citrate and creatinine. This information will be used to determine the cause of the stone. Your child may be asked to have a blood test to help understand the reason her body is forming stones.
The diagnosis, management and treatment of stones is truly multi-factorial. For this reason we created the Stone Center, a sub-division within the Division of Urology that is solely dedicated to the management of kidney stones. Kerry Ashcroft, pediatric nurse practitioner, leads the Stone Center along with a dedicated nursing and scheduling team. We also work very closely with our colleagues in Nephrology (doctors who focus on kidney health) and Metabolism (doctors who focus on genetic disorders that affect the way the chemical reactions happen in the body) to be sure that all factors that may affect a child’s stone disease are addressed.
Reviewed by: Division of Urology
Date: May 2011