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.
A Rise In Kidney Stones Is Seen In Us Children
To the great surprise of parents, kidney stones, once considered a disorder of middle age, are now showing up in children as young as 5 or 6.
While there are no reliable data on the number of cases, pediatric urologists and nephrologists across the country say they are seeing a steep rise in young patients. Some hospitals have opened pediatric kidney stone clinics.
The older doctors would say in the 70s and 80s, theyd see a kid with a stone once every few months, said Dr. Caleb P. Nelson, a urology instructor at Harvard Medical School who is co-director of the new kidney stone center at Childrens Hospital Boston. Now we see kids once a week or less.
Dr. John C. Pope IV, an associate professor of urologic surgery and pediatrics at the Monroe Carell Jr. Childrens Hospital at Vanderbilt in Nashville, said, When we tell parents, most say theyve never heard of a kid with a kidney stone and think something is terribly wrong with their child.
In China recently, many children who drank milk tainted with melamine a toxic chemical illegally added to watered-down milk to inflate the protein count developed kidney stones.
The increase in the United States is attributed to a host of factors, including a food additive that is both legal and ubiquitous: salt.
Excess salt has to be excreted through the kidneys, but salt binds to calcium on its way out, creating a greater concentration of calcium in the urine and the kidneys.
Natural Remedies To Fight Kidney Stones At Home
Kidney stones are a common health problem.
Passing these stones can be incredibly painful, and unfortunately, people who have experienced kidney stones are more likely to get them again (
However, there are a few things you can do to reduce this risk.
This article explains what kidney stones are and outlines 8 dietary ways to fight them.
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It Is Not Loss Of Kidney Function
Here is another graph. Kidney function was measured using creatinine clearance, a common measure.
It went down with age.
But, it began to fall after urine pH had already fallen quite a bit. In other words, the one was not correlated with the other very well. Correlation is not causation, but the other way around is true. Things that are not correlated are not often related causally.
A more elegant approach is to do another of the multi-variable analyses, which we did. The graph on the right, just above, shows that urine pH fell more or less the same if you did or did not adjust for kidney function. So, it is not BMI and not kidney function.
Without The Extra Alkali Urine Ph Would Fave Fallen Far More
Here is the calculated effect. Urine pH falls far more and far more steadily, and the sexes are now more or less the same.
We think that the actual losses of kidney function and the rising BMI were always important. But, as these would have tended to make the urine acid, rising GI Anion offset their effects.
If you take it away, admittedly by mere mathematics, you see what would happen if there were no compensation.
Do we really think that somehow the intestines know to raise their absorption of alkali?
They have about 10% of all of our neurons, and the brain communicates with the GI tract.
This is all for some future research. But what it tells us is that age itself, for reasons we do not as yet know, lowers urine pH. As a result uric acid stones become far more common, and the phosphate type of stone far less common.
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Drink More Water People
The best way to prevent kidney stones is simple: Drink a lot of water. People with low urine output tend to be more prone to developing stones.
Kidney stones are formed by small pieces of minerals, like calcium, building up in your kidneys as your kidneys filter waste from your blood. If you stay hydrated, theres less of an opportunity for those minerals to build up and chunk together.
You know youre drinking enough water if your pee is pale yellow or clear. Still, its easy to forget to hydrate.
Thats why Harper and Wessells are conducting a study;to see if using smart water bottles that track someones fluid intake can help prevent kidney stones. The bottles send data about how much someone is drinking to an app, which then alerts the participant if they need to drink more.
Being reminded is helpful because even people who have had kidney stones tend to slip up when it comes to hydration, Wessells says.
They do it for a while but then they go back to the way they were. The kidney stone becomes a distant memory, he says.
But just because the memory may fade doesnt mean the costsfinancial and otherwisedo. Kidney stones usually cause people to miss several days of work at least, and the financial burden of emergency department visits and CT scans is high, says Wessells.
Its important for people to understand what their barriers are to fluid intake so we can help them remove those barriers and develop strategies to take in more fluid regularly, he says.
What Other Treatment Choices For Kidney Stones Are Available
Drug treatment is being studied with such drugs as such as calcium channel blockers , steroids and alpha-adrenergic blockers. The idea is that the stone might be dissolved with medication. Other drugs such as K-citrate, thiazides or allopurinol are prescribed to prevent new stones from developing. Most doctors agree that more medical trials are needed.
When SWL is not appropriate or doesn’t work, some people will need ureteroscopy, a technique that goes through the bladder to reach the stone or percutaneous nephrolithotomy, a technique that goes through a small incision created in your back. Some people, in extremely rare cases, even need open surgery, a technique that involves a larger incision in your abdomen. The medical terms for kidney stone surgery are ureterolithotomy or nephrolithotomy.
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Risk Factors For Kidney Stones
“Kidney stones” is a term that covers different types of small, solid crystals. They can have different causes and different food culprits. Some are related to kidney infections. Others form because you have too much of certain minerals in your system.
Genes can play a role, too. Forty percent of the people who get kidney stones have relatives who have them, too. Their bodies may get rid of too much calcium or too little citrate in their pee, for instance.
Other conditions that make kidney stones more likely include:
- Obesity. When youâre overweight, you tend to get them more often. The same is true if you have diabetes.
- Gout. This painful condition happens when uric acid builds up in your blood. That makes crystals form in your joints or kidneys.
- Intestinal surgery. If youâve had certain types of gastric bypass surgery or other intestinal surgery, your risk may go up.
- Hyperthyroidism. It can raise calcium levels in your blood and trigger kidney stones.
- Certain kidney diseases. One example is polycystic kidney disease, in which clusters of cysts grow in your kidneys. Another is medullary sponge kidney, a birth defect that causes cysts to form in the organâs tubes.
Middle-aged men are most likely to get kidney stones, though it can happen to people of any age or sex.
Not All Stones Are Created Equal
In addition to calcium oxalate stones, another common type of kidney stones is uric acid stones. Red meat, organ meats, and shellfish have high concentrations of a natural chemical compound known as purines. “High purine intake leads to a higher production of uric acid and produces a larger acid load for the kidneys to excrete,” said Dr. Jhagroo. Higher uric acid excretion leads to lower overall urine pH, which means the urine is more acidic. The high acid concentration of the urine makes it easier for uric acid stones to form.
To prevent uric acid stones, cut down on high-purine foods such as red meat, organ meats, and shellfish, and follow a healthy diet that contains mostly vegetables and fruits, whole grains, and low fat dairy products. Limit sugar-sweetened foods and drinks, especially those that contain high fructose corn syrup. Limit alcohol because it can increase uric acid levels in the blood and avoid crash diets for the same reason. Eating less animal-based protein and eating more fruits and vegetables will help decrease urine acidity and this will help reduce the chance for stone formation.
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Calcium Oxalate And Calcium Phosphate Stones
Calcium stones are the most common type of kidney stones, and can be either calcium oxalate or calcium phosphate. As mentioned, good hydration is important to prevent calcium stones. It may be surprising, but results of a randomized clinical trial show that people with calcium kidney stones should not cut back on dietary calcium. In fact, they should consume the recommended daily allowance of calcium . Why? Calcium binds to oxalate in the intestine and prevents its absorption through the gut, so there is less in the urine to form stones. Ideally, calcium should come from food. Talk with your doctor before taking calcium supplements, and increasing fluid intake might be beneficial depending on how much calcium you take.
Foods high in oxalates can increase the amount of oxalate in the urine. Consume these in moderation.
Calcium phosphate stones are less common than calcium oxalate stones. Causes include hyperparathyroidism , renal tubular acidosis , and urinary tract infections. It is important to understand if one of these conditions is behind the formation of calcium phosphate stones.
Good hydration can help prevent recurrence of calcium stones. In addition, thiazide diuretics such as hydrochlorothiazide can help the kidney absorb more calcium, leaving less of it in the urine where it can form stones. Potassium citrate is another medication that can bind to calcium and help keep calcium oxalate and calcium phosphate in the urine from forming into stones.
It Is Not The Getting Fatter
We get fatter with age. Everyone knows that. Not everyone does it, but on average we all do. I suppose it is less exercise and too much food, but we are not studying this matter here, now.
Below, you can see body mass index rising with age in this very large set of data patient lab
studies. It goes up in men and women, and it goes up very rapidly between 33 or younger and 50.
But, if you adjust for the BMI, the urine pH fall is not affected.
The urine pH falls about the same in both sexes. Compare the graph just to your left with the one just above.
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Prevent Kidney Stones From Happening To You
The consistent recommendation for people at risk for kidney stones is to drink plenty of fluids and be sure that one voids well over 2 liters of urine a day. A healthy lifestyle with proper diet and exercise will also help.
In addition, preventing urinary tract infections by using the restroom at regular intervals and ensuring that the bladder completely empties at those times may help prevent certain types of kidney stones from forming.
Types Of Kidney Stones
The different types of stones are made of different types of substances. It’s important to know the type of stone you have, so you can know what may have caused it and how to prevent it.
If you pass a kidney stone, you should take it to your doctor so they can send it to the lab and find out what kind it is:
Calcium stones. Most kidney stones are made from calcium, in the form of calcium oxalate. There are two kinds of calcium stones:
Calcium oxalate. Oxalate is a substance made daily by your liver. Some fruits and vegetables, as well as nuts and chocolate, are high in it. Your body absorbs the substance when you eat these foods. Other things that can make the concentration of calcium or oxalate in your urine to rise are taking high doses of vitamin D, intestinal bypass surgery and certain metabolic disorders.
Calcium phosphate. This type of stone happens more often in people with metabolic conditions, like renal tubular acidosis or with people who take medications to treat migraines or seizures.
Struvite stones. These can form from a urinary tract infection . The bacteria that cause the infection make ammonia build up in your urine. This leads to formation of the stones. The stones can get large very quickly.
Uric acid stones. These form in people who lose too much fluid because of chronic diarrhea or malabsorption; eating a high-protein diet; or having diabetes or metabolic syndrome. Certain genetic factors also may increase your risk of uric acid stones.
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Kidney Stones: Common Painful Preventable
Kidney stones have plagued men throughout recorded history; the problem has even been “diagnosed” in Egyptian mummies that date back some 7,000 years. In the modern world, this old problem is more common than ever. In the U.S., the prevalence of kidney stones increased from 3.2% in the mid-’70s to 5.2% in the mid-’90s, and the rates are continuing to rise. At present, kidney stones send almost three million Americans to the doctor each year, including over 500,000 trips to emergency rooms. Between 5% and 10% of all active stone passers may require hospitalization.
It’s a big problem caused by tiny deposits that may be less than a tenth of an inch across. It’s a painful problem that can have serious complications. But it’s a treatable problem and, best of all, a largely preventable one.
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Does The Patient Need Anesthesia
Yes, even though there is no incision, there will be pain. You and your doctor will discuss whether light sedation and local or general anesthetics will be used. The choice depends on the technique, the type of stone and the patient. SWL can be delivered with just mild sedation, but in general, some type of anesthesia–either local, regional or general–is used to help the patient remain still, reduce any discomfort, and this improves the breaking of the stone.
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How Common Are Kidney Stones
Each year, more than half a million people go to emergency rooms for kidney stone problems. It is estimated that one in ten people will have a kidney stone at some time in their lives.
The prevalence of kidney stones in the United States increased from 3.8% in the late 1970s to 8.8% in the late 2000s. The prevalence of kidney stones was 10% during 20132014. The risk of kidney stones is about 11% in men and 9% in women. Other diseases such as high blood pressure, diabetes, and obesity may increase the risk for kidney stones.
Kidney Stone Treatment For Your Child
Stones may pass if your child drinks extra fluids. Medical Expulsive Therapy is a technique in which your physician prescribes a medicine like Tamsulosin to increase the chances of passing a stone. If your child is in a lot of pain or if the stone is large, it may have to be removed or broken up into smaller pieces. Surgery for pediatric kidney stones is necessary when:
- The kidney stone doesnt pass within 15 days, a fever develops or there is constant pain
- The kidney stone is too large to pass naturally
- Urine flow is blocked
- There is an ongoing urinary tract infection
- There is constant bleeding or kidney damage
- A follow-up X-ray reveals the childs kidney stone has become larger;
Procedures to break up childhood kidney stones include:
At Children’s;Health;Comprehensive;Stone;Center, treatment options for pediatric kidney stones include advanced procedures such as robotic-assisted surgery and minimally-invasive techniques to speed your childs recovery, says Dr. Peters.
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How Are Kidney Stones Diagnosed
The doctor will ask about:
- the symptoms and how long they’ve been going on
- your diet
- whether you could be dehydrated
- whether there’s a family history of kidney stones, or urinary or kidney problems
The doctor will do an exam and probably order:
- urine tests
- kidney function tests
- imaging tests, such as ultrasounds, X-rays, or CT scans. These can show a stone’s exact size and location. This helps doctors decide on the best treatment.
When Can Swl Be Used
SWL works better with some stones than others. Very large stones cannot be treated this way. The size and shape of stone, where it is lodged in your urinary tract, your health, and your kidneys’ health will be part of the decision to use it. Stones that are smaller than 2 cm in diameter are the best size for SWL. The treatment might not be effective in very large ones.
SWL is more appropriate for some people than others. Because x-rays and shock waves are needed in SWL, pregnant women with stones are not treated this way. People with bleeding disorders, infections, severe skeletal abnormalities, or who are morbidly obese also not usually good candidates for SWL. lf your kidneys have other abnormalities, your doctor may decide you should have a different treatment. lf you have a cardiac pacemaker, a cardiologist will decide if you can have SWL.
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