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Kidney Stones—Child

(Renal Colic—Child; Renal Lithiasis—Child; Nephrolithiasis—Child; Renal Calculi—Child)

Definition

Kidney stones are crystallized material in the urine. These stones form in the kidneys or other parts of the urinary tract. Kidney stones may be made up of a variety of minerals in the blood. The most common are calcium, oxalate, or phosphate. Others stones may contain uric acid, struvite, and/or cystine.
Kidney Stone
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Causes

Some of the known causes of kidney stones in children include:

Risk Factors

Factors that may increase your child’s chance of developing kidney stones include:

Symptoms

Occasionally, kidney stones do not cause symptoms, and they leave the body in the urine. Often a kidney stone can cause severe pain and symptoms such as:

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done.
Images of the kidneys and urinary tract may be taken with:
A 24-hour urine test may also be done to look for levels of minerals in the urine including calcium, phosphorus, uric acid, oxalate, and citrate.

Treatment

Treatment depends on the size and location of the kidney stone. Treatment may include:

Water

For small kidney stones, having your child drink plenty of water will help their body pass the stone in the urine. The doctor may provide a special cup to catch the stone when it passes so that it can be analyzed. If your child is having a hard time keeping fluids down, he or she may need to be hospitalized to receive fluids through an IV. The doctor may also give your child medications to control pain and antibiotics until the stone passes.

Medication

Your child may be advised to take:
  • Over-the-counter pain relivers
  • Prescription pain relievers
  • Medication to dissolve the kidney stone

Surgery

Surgery may be needed if the stone is:
  • 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
Types of surgery include:
  • Extracorporeal shock wave lithotripsy (ESWL)—uses shock waves to break up stones that are too large 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.
  • Percutaneous nephrolithotomy—uses a scope placed through a small tube in the back to remove a large stone (rare)
  • Lithotomy—open surgery to remove a stone (rare)

Prevention

Your child is likely to have another kidney stone if they had one before. To help reduce your child's chance of future stones:

RESOURCES

National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov

Urology Care Foundation http://www.urologyhealth.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

The Kidney Foundation of Canada http://www.kidney.ca

References

Borghi L, Meschi T, et al. Dietary therapy in idiopathic nephrolithiasis. Nutr Rev. 2006;64:301-312.

Kidney stones. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/k/kidney-stones. Updated March 2016. Accessed March 10, 2016.

Kidney stones. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/kidneystones.cfm. Published 2015. Accessed March 10, 2016.

Nephrolithiasis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 24, 2016. Accessed March 10, 2016.

6/23/2014 DynaMed's systematic Literature Surveillance http://www.ebscohost.com/dynamed. Elderwy AA, Kurkar A, et al. Dissolution therapy versus shock wave lithotripsy for radiolucent renal stones in children: a prospective study. J Urol. 2014;191(5 Suppl):1491-1495.

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