What To Expect After Treatment For Kidney Stones
Although each person is different, there is about a 50 percent chance of having another stone within the next five years. To help us determine what caused the kidney stone, we may ask your child to collect urine for 24 hours after a stone has passed or been removed to measure urine volume and levels of acidity, calcium, sodium, uric acid, oxalate, citrate and creatinine. Your child may also be asked to have a blood test to help us understand the reason her body is forming stones.
Lifestyle Choices Help With Kidney Stone Prevention
- Drink a lot of water.Your childsurine should be almost clear. If your childs urine is dark, the more at risk they are to form kidney stones. Talk to your childs pediatrician about how much water they need to drink each day.
- Avoid certain foods. Talk to your childs pediatrician or a nephrologist about foods to add or avoid in your childs diet. This will depend on the type of stones the child is at risk for forming in their urinary tract.
- Healthy diet and regular exercise. Help your child lead a healthy lifestyle to prevent obesity, which is also a risk factor for stone formation.
I hope you learned something new about kidney stones and feel prepared to help manage and prevent kidney stones from affecting your child.
Risk Factors For Kidney Stones
There are many risk factors for forming kidney stones. Some of the most common ones are:
- Family tendency to form stones
- A diet high in salt, meat, and processed foods, and low in fruits and vegetables
- Low urine output from not drinking enough fluid
Other risk factors include:
- Specific inherited conditions
- Certain medicines, such as the seizure drug topiramate, for example, or the blood pressure drug furosemide, which removes excess water from the body
- Blocked urine flow
- Kidney infection
- Not enough physical activity, as when wearing a cast after surgery. This can cause calcium to leave the bones, so that an excess amount builds up in the urinary tract and contributes to stone formation.
- Bowel disease
- Surgery for weight loss
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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.
Causes Of Kidney Stones In Teenagers
There are many causes of kidney stones. A teen having a kidney stone has an underlying condition that increases the risk of kidney stone development.
Following are general causes for kidney stones :
Not drinking enough water causes concentration of uric acid in urine may increase. Chances of developing crystals resulting in kidney stone increases due to high urine saturation.
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Where Kidney Stones Grow
With that in mind, and to begin with, what exactly do we know?
One thing we know for certain: clinically significant calcium oxalate kidney stones grow in human kidneys attached to plaque deposits of calcium phosphate embedded within kidney tissue.
Another: Calcium phosphate deposits plug the terminal ends of kidney tubules. On the open ends of such plugs ends that face onto the urine small rounded overgrowths form. They contain mixtures of calcium oxalate and calcium phosphate. We believe they detach and grow into significant stones stones big enough to cause pain, obstruction, need for surgery. But we do not know for sure because we see and harvest overgrowths only a few millimeters around too small to do much to patients.
Often we find stones attached to nothing. They bear on their surfaces no traces of a prior attachment site. We believe such stone stones form in urine not necessarily attached to anything.
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.
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Why Are More Teenagers Getting Kidney Stones
Dr. Alon: Weve definitely seen an increase in kidney stones over the last several years. Nationally, theres been a 3-4 fold increase among teenagers. Were seeing more cases partly because we have better diagnostic tools in the Emergency Room. Instead of a simple x-ray, we now get a CT of the patients abdomen, which is a much better tool to diagnosis kidney stones.
However, the bigger contributor to the increase in kidney stones is excess salt. For adults, the recommended sodium intake is a maximum of 2300 mg. Teenagers should consume much less and maximum consumption is based on the childs size. For instance, if the teenager is half the size of an adult that teenager should only have half the recommended amount, which would be 1200-1400 mg.
Also just as important, teenagers are not eating enough fruits and vegetables, which contain potassium and counteracts sodium. Its this imbalance in sodium and potassium that results in excess of calcium that triggers kidney stones.
What Are The Symptoms Of Kidney Stones In Children
Symptoms of kidney stones in children include
- sharp pains in the back, side, lower abdomen, or groin
- pink, red, or brown blood in the urine, also called hematuria
- a constant need to urinate
- pain while urinating
- inability to urinate or can urinate only a small amount
- cloudy or bad-smelling urine
- irritability, especially in young children
A child should see a health care professional right away when any of these symptoms occur. These symptoms can be caused by a kidney stone or a more serious condition.
The pain of a kidney stone may last for a short or long time or may come and go in waves. Along with pain, a child may have
- nausea
- fever
- chills
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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.
What Causes Kidney Stones In Children
Most kidney stones are caused by high levels of calcium, oxalate, or phosphorus in the urine. These minerals are normally found in urine and do not cause problems at normal levels.
Certain foods and beverages may increase the chances of having a kidney stone in children who are more likely to develop them.
When children cant move for a long time, for example when a child is in a cast after surgery, the chances of developing a kidney stone are higher. When children arent moving, their bones may release extra calcium into the blood.
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How Can Your Child Be Treated For Kidney Stones
There are a few ways to treat kidney stones. Unfortunately, we dont have a way to dissolve them just yet. If the stone is found by accident during a test for another reason, its recommended that you talk with a pediatric urologist or kidney surgeon about different ways to manage it. If the stone is in the process of passing, your doctor may recommend letting the body pass it on its own with the help of special medicines. These medicines help ease pain and relax the muscles in the ureter, making it wider so that stones can pass through more easily. Drinking lots of water will also help your child push out a stone.
Once the stone has made its way out, your childs doctor will want to examine it to learn more about its consistency. To help catch the stone, your child will be asked to urinate through a straining device. If the stone gets stuck or is too big to pass on its own, your doctor may recommend treatments to break down and remove the stone. The amount of time it may take the stone to pass will vary based on the individual, stone size and location at diagnosis, with smaller stones that are farther along being more likely to pass on their own.
What Should Parents Be Aware Of
According to Dr. Lane, parents should be diligent about making sure their children are taking in enough fluids throughout the day. The most important prevention for kidney stones is drinking lots of fluid, she shares. The urine should appear clear or pale yellow. A lot of kids do not want to use the restroom during the day, especially once they enter high school. We need to encourage them to drink more and urinate. As a parent, you need to be somewhat aware of your childs habits, and to make sure they are using the restroom at regular intervals. If your child has stones, watch for sodium in the diet. Remember, sports drinks contain sodium that can promote kidney stones, Dr. Lane adds.
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What Is A Kidney Stone
Kidney stones form in the urinary system when the water and waste in your child’s urine are out of balance. When this happens, certain types of waste crystals separate from the urine. The crystals build up and form kidney stones. Kidney stones can be made of uric acid, calcium, phosphate, or oxalate crystals. Your child may have more than one kidney stone.
What Are Kidney Stones
Kidney stones are hard, pebble-like pieces of material that form in one or both of a childs kidneys when high levels of certain minerals occur in urine. Kidney stones rarely cause permanent damage if treated by a health care professional.
Kidney stones vary in size and shape. They may be as small as a grain of sand or as large as a pea. Rarely, some kidney stones are as big as golf balls. Kidney stones may be smooth or jagged and usually are yellow or brown.
A small kidney stone may pass through the urinary tract on its own, causing little or no pain. A larger kidney stone may get stuck along the way. A kidney stone that gets stuck can block the flow of urine, causing severe pain or bleeding. Learn more about the urinary tract and how it works.
A child who has symptoms of kidney stones including severe pain, blood in the urine, or vomiting needs care right away. A health care professional, such as a urologist, can treat any pain and determine how and when to treat the kidney stone. The provider may also prescribe medicine to prevent further problems or treat a urinary tract infection .
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What Is Pediatric Nephrolithiasis
Pediatric kidney stones vary in shape and size, from the size of a grain of sand to the size of a golf ball . When these stones are larger than the urinary tube, they can get lodged in the urinary tract and cause intense pain.
Stones pass from the kidney to the ureter . Some kidney stones are small enough to pass without being noticed. Others are larger than the tube and become stuck when trying to pass through. This leads to a urine backup in the kidney, ureter, bladder or the urethra wherever the stone is stuck.
How Do I Know If My Treatment Is Working
Because cystine stones tend to reoccur, it is important to know your treatment is working and lowering your cystine level. A 24-hour urine collection is a way of checking cystine levels. Your healthcare provider may ask you to do a 24-hour urine collection to check your level. The results will help determine whether any adjustments to your treatment is needed.
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Prevention Of Future Stones
Once your health care provider finds out why you are forming stones, he or she will give you tips on how to prevent them. This may include changing your diet and taking certain medications. There is no âone-size-fits-allâ diet for preventing kidney stones. Everyone is different. Your diet may not be causing your stones to form. But there are dietary changes that you can make to stop stones from continuing to form.
Diet Changes
Drink enough fluids each day.
If you are not producing enough urine, your health care provider will recommend you drink at least 3 liters of liquid each day. This equals about 3 quarts . This is a great way to lower your risk of forming new stones. Remember to drink more to replace fluids lost when you sweat from exercise or in hot weather. All fluids count toward your fluid intake. But itâs best to drink mostly no-calorie or low-calorie drinks. This may mean limiting sugar-sweetened or alcoholic drinks.
Knowing how much you drink during the day can help you understand how much you need to drink to produce 2.5 liters of urine. Use a household measuring cup to measure how much liquid you drink for a day or two. Drink from bottles or cans with the fluid ounces listed on the label. Keep a log, and add up the ounces at the end of the day or 24-hour period. Use this total to be sure you are reaching your daily target urine amount of at least 85 ounces of urine daily.
Reduce the amount of salt in your diet.
Eat the recommended amount of calcium.
Can Kids Get Kidney Stones
I had no idea that kids could get kidney stones. This is something I hear frequently from parents whose children present with their first kidney stone to the urology clinic at Nationwide Childrens Hospital. While kidney stones are much more common in adults, both babies and children can and do get kidney stones. Kidney stones in childhood are becoming more frequent than they used to be, and boys are slightly more at risk to get stones than girls.
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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.
What Are The Types Of Kidney Stones
The four major types of kidney stones are:
1. Calcium stones: The most common kind of kidney stone, these grow when calcium in the pee combines with other substances to form crystals.
2. Cystine stones: These are rare and form when there is too much cystine in the urine.
3. Uric acid stones: These form when there is too much uric acid in the pee. Uric acid can crystallize by itself or combine with calcium to form a stone.
4. Struvite stones: Also called staghorn calculi because they can look like a stag’s antlers. These are made of a mineral called struvite. Struvite stones are almost always due to an infection of the kidneys or urinary tract. They’re more common in females, can grow rather large, and can be more harmful to the kidneys than other stones.
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Risk Factors For Developing Kidney Stones
According to the National Institutes of Health , 1 out of every 10 people will develop kidney stones during their lifetime. Renal stone disease accounts for 7-10 out of every 1,000 hospital admissions.
Diet, genetics and lifestyle can all contribute to kidney stones. Several risk factors play major roles in stone formation:
- Loss of body fluids . If your child does not drink enough fluids during the day, the urine can become quite concentrated and dark. This increases the chance for crystals to form in the urine because there is less fluid available to dissolve them.
- Diet. The type of food your child eats can also affect his chances of getting kidney stones.
- A high-protein diet can cause the acid in the body to increase. This decreases the amount of urinary citrate, a “good” chemical that helps prevent stones. As a result, stones are more likely to form.
- A high-salt diet is another risk factor. An increased amount of sodium passing into the urine can pull calcium along with it. This increases calcium levels in the urine, which increases the chance for stones. Eating oxalate-rich foods such as leafy green vegetables, tea or chocolate may make things worse.