KIDNEY STONES
Kidney (or renal) stones are clusters of tiny crystals that can form in the kidneys. Most clusters are too small to cause any problems and pass out of the body in the urine. Sometimes, the clusters can clump together to form bigger clusters, which may eventually become big enough to block the filtering units in the kidney.
Sometimes, they pass out of the kidney down the ureter and out in the urine without causing any problems, but if they are big they may block the ureter or lodge in the bladder.
Kidney stones are much more common in adults than in children. Children who have kidney stones will be checked thoroughly to rule out or confirm an underlying condition causing the problem. This could include a structural abnormality with the urinary system or a problem with the metabolism.
Causes / Risk Factors for Kidney Stones
Factors that place a child at increased risk for developing kidney stones are:
- Family history of stones
- Decreased water intake or long periods of dehydration
- Repeated urinary tract infection
- Diet high in sodium and/or protein
- Obesity
- Decreased activity level
- Defects in the urinary tract
- Use of certain medications
Types of Kidney Stones
The four main types of kidney stones are:
- Calcium Stones These are the most common type of kidney stones. They occur in two major forms calcium oxalate and calcium phosphate.
- Cystine Stones Result from a genetic disorder where cystine leaks through the kidneys into the urine.
- Uric Acid Stones Form when the urine has too much acid in it. A diet rich in animal proteins may contribute to this kind of stone.
- Struvite Stones Form when someone has frequent urinary tract infections.
Signs and Symptoms of Kidney Stones
A child may have a sudden, severe pain in the side of the body. The pain can spread out to the belly, groin or genitals. It may be so painful that the child is unable to find a comfortable position. Other symptoms include:
- Pain with urination
- Blood in the urine
- Frequent / persistent urinary tract infection
- Urinary urgency and/or frequency
- Nausea / vomiting
- Fever
How are kidney stones normally diagnosed?
Various imaging scans may be needed to confirm the diagnosis, see where the kidney stones are located and their size. An ultrasound scan is usually the first test to help make the diagnosis, although other scans may be needed as well. Urine tests will be needed to show whether there is an infection and to measure the chemicals that cause stones. Blood tests will show how well the kidneys are working. Plain X ray KUB or CT scan may be required to guide further management.
How are kidney stones normally treated?
This depends on their size and location. Smaller stones can be broken up using sound waves (lithotripsy). Some stones that are stuck in the ureter can be removed using an endoscope, a tube containing a small camera, a light and a laser device to break up the stone. Large or multiple stones in kidney are removed using a keyhole-type surgery.
What happens next?
After the surgery, we get the analysis of the stone and look for the type. A small number of children have metabolic conditions that lead them to form stones throughout their life and extra treatment will be necessary to minimise these episodes. Your baby may need the services of Pediatric Nephrologist to help prevent the recurrence of stone formation.