Kidney stone disease (nephrolithiasis) is a chronic metabolic disease that includes periodic return of symptoms. Stone recurrence – or return of kidney stones – is common. Reducing the likelihood of recurrence is a key focus of treatment, and an important measure of successful outcomes and long-term well-being.
The incidence of kidney stone disease in children has risen dramatically over the last 25 years. However, there has been very little research done to assess how to decrease the risk of recurrence of kidney stones, particularly in the pediatric population.
Since 2008, the Pediatric Kidney Stone Center has been collecting data on stone recurrence in pediatric patients. Establishing a benchmark is an important first step in determining the rate of stone recurrence in children and adolescents. Understanding what contributes to stone recurrence in pediatric patients and when it occurs will help us take the next step to improve treatment options with the goal of lowering recurrence rates.
Measuring stone recurrence
There are different ways of assessing a patient for stone recurrence. At The Children’s Hospital of Philadelphia, we use ultrasound to evaluate children with suspected kidney stones and monitor children for stone recurrence after treatment. The American Urological Association and the European Society of Pediatric Radiology recommend ultrasound as the initial diagnostic imaging study for children with suspected stones because ultrasound is a safe, noninvasive and effective way to identify the presence of stones.
A follow-up ultrasound one month after the stone is initially removed is the first benchmark to determine if your child remains “stone free.” This is followed by renal bladder ultrasounds and repeated urinalysis every six months.
Managing stone recurrence in kids
The risk of kidney stone recurrence in children is high. Early data shows that within three years of initial treatment for kidney stones, 50 percent of kids have had a recurrence. These rates are similar to, if not higher than, the rate of recurrence seen in adults.
This reinforces the need for a dedicated team focused on the unique management of kidney stones in the pediatric population. Children are a unique patient population with special medical needs, and may have different risk factors than adults. It takes a specialized team to understand and effectively treat and manage their disease. Our team is equipped to provide this specialized care, both surgically and in terms of ongoing disease management.
This ongoing research will help us better understand how stone disease affects children and adolescents so we can tailor treatments and prevention methods, reduce recurrence, and improve outcomes.
For more about preventing kidney stones in children, read: