Kidney Stones And Teens: Causes Symptoms And Prevention
Most likely you or someone you know has experienced kidney stones, which are hard deposits of minerals and salts formed in the kidney and can be painful to pass. While more common in adults, cases of kidney stones in children have increased significantly in recent years, especially in teenagers. We sat down with Dr. Uri Alon, director, Bone and Mineral Disorders Clinic at Childrens Mercy, to find out why this is the case and what can be done to prevent kidney stones.
Does Your Child Have A Kidney Stone
If you think your child has a kidney stone, consult a health care professional. Your pediatrician or pediatric urologist evaluates your childs kidney stone symptoms and medical history, conducts a physical exam, and orders tests to diagnose a childhood kidney stone and find out what may have caused it.
Imaging tests tell us the size, location and amount of stones your child has, says Dr. Peters. An abdominal X-ray can pinpoint a stone in the kidneys or ureters. A renal bladder ultrasound helps us find a stone and signs of blockage. If these tests dont tell us the information we need, we can perform an abdominal/pelvic CT scan.
What Is The Treatment For Kidney Stones
Most often, non-surgical approaches are taken when treating small kidney stones, with most of the focus on managing the childs pain. Children waiting to pass stones at home should urinate into a coffee filter, loose tea filter or urine strainer, so that the stone can be collected and brought into the urology center to be analyzed under a microscope.
Today, minimally invasive treatment is used for almost all large or obstructing kidney stones. Although the majority of smaller stones will pass without a medical procedure, large stones that are unlikely to pass through on their own must be broken up by a process known as lithotripsy. Extracorporeal lithotripsy, also called ESWL, uses shock waves from an outside source to break the stones into smaller fragments that can be swept away in urine. This is the most common procedure used to break up large stones.
Sometimes a stone will form or get stuck in the bladder. If this happens, then the child may need a cystoscopy. With this procedure, a small telescope is passed up the urethra to the bladder. The stone is then removed by passing a basket-like device up the scope to retrieve it. This is often done when stones are larger or have irregular shape and is done under general anesthesia.
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What Are The Most Common Types Of Kidney Stones
The most common type of kidney stone is a calcium oxalate stone. This type happens when calcium and oxalate combine in your urine. It can happen when you have high quantities of oxalate, low amounts of calcium and arent drinking enough fluids.
Stones caused by uric acid are also fairly common. These come from a natural substance called purine, which is a byproduct of animal proteins .
Dehydration Inactivity & Sodium Play A Role
If a kidney stone is diagnosed, your childs urine is collected for 24 hours. It is then sent to a lab to test the mineral content and levels, the amount of each mineral in the urine and note the amount of urine produced which will evaluate for metabolic disorders such as diabetes.
Its rare for me to find a metabolic disorder, but almost every patient Ive seen has a low volume of urine. If youre not making enough urine, youre probably not taking in enough fluid, says Dr. Rhee.
Since fluids help flush minerals through your urinary system, not staying hydrated is associated with developing kidney stones. Lots of kids think they drink enough water, but especially if theyre active, they need to drink more, says Dr. Rhee.
So how much water is enough? For kids over 12, I recommend from 2 to 2 1/2 liters of water a day, Dr. Rhee says. For a younger child, 1 to 1 1/2 liters.
A sedentary lifestyle and a high sodium intake in the diet are also associated with the development of kidney stones, notes Dr. Rhee. Fast food and highly processed foods, staples in the average American diet, are key offenders.
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How To Prevent More Kidney Stones In The Future
Kids with kidney stones have a 50% lifetime risk of having a recurrence. We hit home that they need to drink more water, drink the lemonade and try to avoid sodium, Dr. Rhee says. That means potato chips, pretzels, pizza and all that kind of junk food.
As a final note to parents help your kids stay away from high-sugar, high-calorie drinks, and make sure your child increases his or her fluid intake in hot weather or with exertion. Its important to also continue to encourage physical activity so they can live their most-fun kid days!
How Are Children Treated For Kidney Stones
Most childrens kidney stones can be treated with the shock wave lithotripsy , a completely non-invasive procedure. Your child is placed under anesthesia and sound waves of specific frequencies are focused on the stones to shatter them into fragments small enough to be easily passed during urination.
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Are There Any Foods Or Drinks That Help Treat Kidney Stones Are There Any Home Remedies
There are three liquids rumored to help with kidney stones:
- Cranberry juice. Although cranberry juice can help prevent urinary tract infections , it doesnt help with kidney stones.
- Apple cider vinegar. Vinegar is acidic and it can sometimes create changes to your urine, which helps with kidney stones. But, this doesnt always help. Talk to your healthcare provider about the use of vinegar.
- Lemon juice. Lemon juice is rich in citrate, which can help prevent kidney stones from forming. Citrates are found in several citrus fruits including lemons, limes, oranges and melons.
- Coffee. Studies show that coffee may decrease your risk of developing kidney stones.
Avoid soda and other drinks with added sugar or fructose corn syrup. They increase your risk.
Causes And Symptoms Of Kidney Stones
There are multiple causes and contributing factors to kidney stone formation. Here are the main causes of kidney stones:
- Bacteria from urinary tract infections
- Certain medications
- Problems with formation of urinary tract inside the body
The four main symptoms of kidney stones are:;
If you are concerned your child has or may have kidney stones, it is very important to talk to their pediatrician. Your childs pediatrician may recommend referral to a pediatric urologist to discuss stone removal or a pediatric nephrologist to discuss ongoing management and stone prevention. If your child is suffering from intense pain with nausea and vomiting, then they should be taken to the emergency department for prompt evaluation. Note: If your child passed a kidney stone and you find it, place it in a plastic bag and take it to their pediatrician.
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Yes Kids Canand Doget Kidney Stones
Kids can get kidney stones, just like adults. Once thought to be mostly an adult disease, these pesky pebbles are being found more and more in children. In fact, the incidence of kidney stones in kids is increasing even faster than that of bronchitis and appendicitis*.
While we dont know the exact reason why kidney stones are forming in children more often, the increase in kidney stone rates in kids has paralleled an increase in average body mass index , and some studies suggest a correlation with poorer diet**.
At Childrens Healthcare of Atlanta, we see an average of more than 150 patients with kidney stones each year, ranging from 1 month to 17 years old. Recently, weve also started seeing patient volumes spike during the summer as temperatures in Georgia rise, says Michael Garcia-Roig, MD, Pediatric Urologist.
How Are Kidney Stones Treated
Treatment depends on the type of kidney stone and its size. Some kids only need to drink a lot of water and take pain medicines to pass a kidney stone. Those with larger stones may need surgery or other treatments to help remove the stones.
There are different types of stones. A stone that passes in pee and is caught in a strainer can be tested to see what type it is. Knowing that can help doctors find the cause and offer advice how to treat it and prevent other stones.
To help pass a small stone, give your child plenty of water to drink and medicine to ease the pain. Often, over-the-counter medicines such as ibuprofen and acetaminophen are enough. But sometimes, doctors prescribe pain medicine.
The doctor might ask you to strain your child’s pee for a few days to collect the kidney stones. Examining them can help the doctor decide if your child needs more treatment.
Kids whose kidney stones block the urinary tract or cause severe pain or dehydration may need care in a hospital. They might get intravenous fluids and pain medicine to help the stones pass and treat dehydration.
Large stones rarely pass on their own. To get rid of large stones and stones that are damaging the kidneys, doctors can do a procedure to break up the stone. This lets the smaller pieces pass on their own or be removed with a scope or surgery.
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How To Help Preventing Kidney Stones
There are many things that you can help your child do to reduce the chances of developing more kidney stones. Children with kidney stones should:
- Drink a lot of fluid throughout the day . Ask your healthcare team for an amount that’s right for your child. If your child has kidney disease and needs to limit fluid, please discuss this with the team.
- Limit salt in the diet.
- Eat more fruits and vegetables, especially citrus fruits.
- Eat fewer meats, processed foods, fast food, and sodas.
- Avoid food and drinks with high fructose corn syrup.
- Keep a healthy weight.
- Eat the recommended amount of calcium-rich foods and drinks.;Cutting back calcium in the diet is not recommended and can sometimes actually increase stone risk. On the other hand, don’t take a calcium supplement unless your doctor says your child needs one.
Your doctor may also recommend that your child see a pediatric nephrologist, a kidney specialist who treats children with kidney stones. Blood tests and a 24-hour urine collection test may determine why your child formed a kidney stone. With this information, a registered dietitian nutritionist can make specific dietary recommendations and your doctor and health care team can prescribe medicines to reduce your child’s risk for making future kidney stones.
What Are Kidney Stones
Kidney stones are also known as renal calculi or nephrolithiasis. They typically occur in adults, but can affect children as well and can occur even in babies. Kidney stones form when high amounts of certain substances accumulate in the kidneys, forming crystals or a stone. Certain stones are caused by other diseases but many are related to diet and nutrition. Some doctors note anecdotal evidence that more children are getting this condition, possibly due to too much salt in their diets.;
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Going A Small Amount At A Time
Large kidney stones sometimes get stuck in a ureter. This blockage can slow or stop the flow of urine.
If you have a blockage, you may only urinate a little bit each time you go. Urine flow that stops entirely is a medical emergency.
These symptoms happen because of shared nerve connections between the kidneys and GI tract . Stones in the kidneys can trigger nerves in the GI tract, setting off an upset stomach.
The nausea and vomiting can also be your bodys way of responding to intense pain .
How Can It Be Treated
There are various treatments that can be used when it comes to kidney stones, and it varies depending on the severity.
A form of treatment called Extracorporeal shock wave lithotripsy might sound scary, but all it is is that it uses sound waves to crush kidney stones inside the body. It’s a painless form of treatment, and it’s very effective in breaking up kidney stones.
For larger stones, surgery can sometimes be an option, but that is usually the last resort if the stones can’t be treated through other means.
There are also medicines that doctors prescribe to help break up the kidney stones so that your children can pass it through their urine. However, that in itself can be a painful experience.
Doctors can also prescribe pain medication to children suffering from kidney stones in order to help alleviate the pain. The pain can sometimes become so severe that it can cause nausea and vomiting, so pain management is very important.
Lastly, the best thing to do when it comes to kidney stones would be to prevent them from happening in the first place. Make sure that your child has a healthy diet, and ensure that they’re drinking lots of water so that there won’t be any buildup of stones in their kidneys.
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Can A Large Kidney Stone Cause An Injury
Your risk of injury from a kidney stone can go up based on the size and location of the stone. A larger stone could get stuck in a ureter, causing pressure to build up. This can lead to renal failure and, in the worst-case scenario, you could lose your kidney. The chance of passing a 1 cm stone is less than 10%, and stones larger than 1 cm typically dont pass.
How Will My Childs Kidney Stones Be Treated
Some smaller stones in the kidney and ureter may pass in the urine just by drinking more fluids and taking certain medications, but other stones may need to be broken up and removed by surgery.
At Nationwide Childrens, my pediatric urology colleagues and I have undergone several years of additional training in all forms of stone removal surgery for children and adolescents. This includes shock wave procedures and other minimally invasive techniques with the latest and most advanced surgical equipment for stone surgery, including specialized pediatric-sized telescopes and laser technology for removing kidney stones.
In cooperation with the pediatric nephrologists at Nationwide Childrens, we are the best place in central Ohio and beyond to;care for any child;with kidney stones.
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Why Are We Seeing These In Children
Pascale H. Lane, M.D. is a pediatric nephrologist who deals with pediatric kidney stone patients. She is also a professor of pediatrics at the Oklahoma University Health Sciences Center. We asked if, in her experience, there has been an increase in kidney stones in pediatric patients in recent years. The rate of kidney stones in children seems to be on the rise in recent years, she shares. Familial factors, such as extra calcium in the urine, can cause children to develop stones. Sodium and calcium handling in the kidney are linked, and excess sodium in the diet can promote stone formation as well, she shares. Obesity is also associated with kidney stone risk. The recent rise in stones may be due to sodium intake from processed foods and the rise of childhood obesity.
Calcium Is Not The Enemy
But it tends to get a bad rap! Most likely due to its name and composition, many are under the impression that calcium is the main culprit in calcium-oxalate stones. “I still see patients who wonder why they are getting recurring stones despite cutting down on their calcium intake,” said Dr. Jhagroo. “I’ve even had patients say that their doctors told them to reduce their calcium intake.” A diet low in calcium actually increases one’s risk of developing kidney stones.
Don’t reduce the calcium. Work to cut back on the sodium in your diet and to pair calcium-rich foods with oxalate-rich foods.
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Should I Cut Calcium Out Of My Diet If I Develop Calcium Oxalate Kidney Stones
If you develop kidney stones composed of calcium, you may be tempted to stop eating foods that include calcium. However, this is the opposite of what you should do. If you have calcium oxalate stones, the most common type, its recommended that you have a diet higher in calcium and lower in oxalate.
Foods that are high in calcium include:
- Cows milk.
Its also important to drink plenty of fluids to dilute the substances in your urine.
What Are The Signs And Symptoms Of Nephrolithiasis In Children Is It The Same As In Adults
The first important step in kidney stones or urolithiasis is diagnosis of the condition. The common mode of diagnosis is an incidental pick-up when an ultrasound scan of the abdomen is done for any reason. However, we need to take care to note that all that glitters is not gold! Hence every scan report that mentions a kidney stone is not necessarily diagnostic or confirmatory of a kidney stone. The size of the stone matters and when the size is less than 5 mm, the probability of a stone being present decreases as is described below.
With regards to the symptoms, we need to understand that as long as the calculus/stone is in the kidney, there are virtually no symptoms. The symptoms occur when the stone starts travelling down the ureters . Hence one may have a fairly large stone sitting in the kidney without any symptom whatsoever.
Sometimes the calcification is within the parenchyma of the kidney and that is called as nephrocalcinosis. That is not a stone and will not travel down the ureters.
When the stone travels down the ureter, there are severe symptoms. There is often colicky abdominal pain associated with vomiting, blood in the urine , flank pain and there maybe dysuria . However, one needs to be careful when we attribute symptoms that a child has to a kidney stone. If there is a 2-3 mm calculus sitting within the kidney and the child has red coloured urine , it is unlikely to be because of that stone
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