Kidney Stones -- Child
Kidney Stones—Child
(Renal Colic—Child; Renal Lithiasis—Child; Nephrolithiasis—Child; Renal Calculi—Child)
Definition
- The most common type is mostly calcium, along with oxalate or phosphate.
- Others types contain uric acid, struvite, and/or cystine.
| Kidney Stone |
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Causes
- Too much oxalate in the urine
- Too much calcium in the urine or blood
- Too much uric acid in the urine
- Tiny bacteria a stone can form around
- Inherited abnormality in the way the body handles cystine
- Foreign bodies in the urinary tract, like stents or catheters
- Abnormal function of the urinary tract, such as neurogenic bladder
Risk Factors
- Dehydration —not drinking enough fluids
- Eating foods high in salt
- Eating a ketogenic diet to help control epilepsy
- Mineral content of water your child drinks (hardness or softness of the water)
- Having family members who have had kidney stones or gout
- Having kidney stones in the past
- Being overweight
- Medical conditions (eg, urinary tract infections , metabolic conditions)
- Geographic location (residents of the Southeast United States have an increased risk)
- Limited physical activity
- Foreign material in the urinary tract (eg, catheter)
Symptoms
- Sudden, severe pain in the side of the body or mid- or lower back
- Pain in the belly or groin area
- Nausea or vomiting
- Blood in the urine
- Burning pain when urinating
- Fever
- Recurring urinary tract infections
Diagnosis
- Spiral CT scan—a type of x-ray that uses a computer to make pictures of the inside of the kidney
- KUB (kidney, ureter, bladder)—an x-ray that uses radiation to view the urinary tract
- Ultrasound —a test that uses sound waves to examine the kidneys
- Intravenous pyelogram (IVP) —a special x-ray that produces images of the urinary system (less commonly used today)
- 24-hour urine—a urine test to check levels of many factors, including calcium , phosphorus , uric acid, oxalate, and citrate
Treatment
Water
Surgery
- Very large or growing larger
- Causing bleeding or damage to the kidney
- Causing infection
- Blocking the flow of urine
- Unable to pass on its own
- Stent placement—used to allow urine to pass
-
Ureteroscopy and stone basketing or laser lithotripsy—camera is used to locate the stone
- Stone basketing—A tiny basket is used to remove the stone.
- Laser lithotripsy—The stone is broken into smaller pieces with a laser if it is too large to remove.
- Extracorporeal shock wave lithotripsy (ESWL) —uses shock waves to break up stones that are too large to pass
- Percutaneous nephrolithotomy—uses a scope placed through a small tube in the back to remove a large stone
- Lithotomy—open surgery to remove a stone (rarely used now)
Prevention
- Have your child drink plenty of fluids, especially water. Avoid sodas.
- Make sure your child does not eat too much food that is high in salt (eg, potato chips, French fries, processed meats, etc.).
- A calcium-rich diet (eg, milk and yogurt) is fine, but avoid giving your child too much calcium.
- If your child is overweight, work with your child’s doctor to learn the safest way for your child to lose weight.
RESOURCES
American Urological Association Foundation http://www.urologyhealth.org/
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/
National Kidney Foundation http://www.kidney.org/
CANADIAN RESOURCES
Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/
The Kidney Foundation of Canada http://www.kidney.ab.ca/
References
American Urological Association. Clinical guidelines: ureteral calculi (’07). American Urological Association website. Available at: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=uc&CFID=2654109&CFTOKEN=47752467&jsessionid=84309dfcd2da7030200143065621c2a50406 . Accessed July 13, 2010.
Borghi L, Meschi T, Maggiore U, Prati B. Dietary therapy in idiopathic nephrolithiasis. Nutr Rev . 2006;64:301-312.
Calcium. EBSCO Natural and Alternative Treatments website. Available at: http://therapy.epnet.com/nat/nat.asp . Updated April 2009. Accessed July 13, 2010.
Campell MF, Wein AJ, Kavoussi LR, eds. Campbell-Walsh Urology . 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
Caple C. Ketogenic diet in children. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16&topicID=860 . Published December 4, 2009. Accessed July 13, 2010.
The Children’s Hospital. Kids and kidney stones: a growing problem. The Children’s Hospital website. Available at: http://www.thechildrenshospital.org/news/publications/shine/winter-2010/kidney-stones.aspx. Created Winter 2010 . Accessed June 29, 2010.
Cincinnati Children’s Hospital. Kidney, bladder, and genitals conditions and diagnoses: bladder/kidney stones. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/info/urinary/diagnose/bladder-kidney-stones.htm#causes . Updated November 2009. Accessed June 29, 2010.
Coe FL, Evan A, Worcester E. Kidney stone disease. J Clin Invest . 2005;115:2598-2608.
Delvecchio FC, Preminger GM. Medical management of stone disease. Curr Opin Urol . 2003 May; 13(3):229-33.
DynaMed Editors. Kidney stones. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 28, 2010. Accessed June 29, 2010.
Kidney stones in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/ . Published October 2007. Accessed July 13, 2010.
Martini LA, Wood RJ. Should dietary calcium and protein be restricted in patients with nephrolithiasis? Nutr Rev . 2000;58:111-117.
National Kidney Foundation. Kidney stones. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/kidneystones.cfm . Created 2010. Accessed June 29, 2010.
Pearle MS, Lingemann JE, Leveillee R, et al. Prospective, randomized controlled trial comparing shock wave lithotripsy and ureteroscopy for lower pole caliceal calculi 1 cm or less. J Urol . 2005;173:2005-2009.
