Kidney stones in children is a relatively uncommon problem in children against adults. However it is seen regularly in children in different ways of presentation. It requires immediate attention with an aim to cure and prevent new stone formation.
Commonly asked questions on kidney stones in children:
Can children “really” have kidney stones?
Yes, children as small as few months to adolescents can have kidney and bladder stones. It is true and is not a rare condition in children.
Why do the small kids have stones?
Kidney stones don’t happen by consuming external stones. Most common reason is genetic association in majority of children if any of close relatives including parents/ grandparents or cousins have had it.
Does kidney stone formation in kidneys happen because of consumption of stones or is there any other reason?
No, this is not true. Kidney stones happen due to super saturation of urine with certain molecules like oxalate, calcium, uric acid etc. This is a natural tendency in some humans and can be increased due to consumption of certain food rich in above molecules.
How does kidney stones in children present?
The usual presentations are reddish urine, pain while passing urine, severe pain in side flanks of abdomen along with vomiting sensation. Many times it is silent stone and is detected if abdomen scan is done for some other reason.
What are the tests required to be done when stone is detected?
Every child with kidney stone must undergo a detailed root cause analysis for the cause and composition of stone. These include X ray, Ultrasound scan, CT scan to check the location and number of stones. Also a series of blood tests are required to check for working capacity of kidneys along with blood levels of components which can contribute stone formation. Urine Metabolic analysis is very important part of evaluation to assess the chemical composition of the stone with an aim to target the therapy.
What damage these stones can create in the kidneys?
Single or multiple stones in kidney which are of small sizes usually don’t create major issues. However, if the stones migrate and get stuck in the ureter (Tube connecting kidney and bladder), then it can create severe pain and obstruction in flow of urine. This can lead to swelling and infection in the kidney which can damage the kidneys. Small multiple untreated stones which have collected in deep tissues of kidney for long periods called as Nephrocalcinosis can lead to Chronic Kidney Disease which can make kidneys weak.
How are the kidney stones treated?
The treatment is mainly medical and sometimes it is surgical. Medical treatment consists of Medications aiming towards Stone formation inhibition and expulsion. Surgical treatment is required in cases where stone is large enough, leading to obstruction in urine flow and if there is failure of medical therapy. Shock Wave Lithotripsy is also another modality which is useful in large stones in kidney.
Do the kids with kidney stones need long term therapy?
Yes, most of the children need long term stone inhibitor therapy. The aim is to reduce the chances of new stone formation or prevent them from enlarging. This is very important and most neglected step too. A combination of syrups and tablet help in this and are suggested for 6 months to 1 year or even longer if required.
Are there some dietary restrictions for children with kidney stones?
The general dietary advice comprises of: Low Salt based diet and Plenty of hydration. Further dietary restrictions are advised as per the reports of blood and urine metabolic screening.
Do such children require regular follow up and why?
Yes, it is advisable for a regular follow up biannually at least for children with kidney stones. This is to keep an eye on the status of stones, their location in kidney and also function of kidneys.