Kidney Stones in Kids: Causes, Symptoms, and Treatment

What Are Kidney Stones?

Kidney stones are hard and rock-like substances that form inside the kidneys. In children, these stones are often small in size. But size doesn’t always reflect the severity of symptoms. Even a tiny stone no larger than a grain of sand can cause intense pain.

Kidney stones form when minerals and salts in the urine are concentrated and stick together. These minerals and salts are such as calcium, oxalate, and uric acid. Over time, these small crystals grow into solid masses, much like how sugar crystals form when making rock candy.

Who Gets Kidney Stones?

Kidney stones are more common in adults. But these are increasingly being seen in children and teenagers. There are multiple factors behind the formation of kidney stones, including family history. Several factors can contribute to their development, including:

Diet: Consuming high salt or processed food.
Dehydration: Having a habit of not drinking enough water.
Obesity: It could be a cause of higher risk due to metabolic changes.
Genetics: Having a family history of kidney stones.
Climate: Children living in warm regions (often called the “stone belt”) may sweat more and urinate less, leading to more concentrated urine.

These risk factors may overlap, making it important to assess each child individually.

How Kidney Stones Cause Problems

Kidney stones usually form in the renal pelvis. It is the part of the kidney where urine collects before flowing into the ureter, a narrow tube that carries urine to the bladder.

Stones often don’t cause pain when resting in the kidney. However, pain begins when a stone moves into the ureter. The ureter is a thin and delicate tube. Especially in children, the ureter is small and thin. Hence, when it is blocked, it prevents urine from draining properly. Pressure builds up behind the stone, which leads to swelling and intense pain.

Common symptoms include:

Severe pain on one side of the back or abdomen
Pain that may shift toward the groin as the stone moves
Nausea and vomiting
Blood in the urine (pink, red, or brown discolouration)
The pain can come in waves and is often described as one of the most severe types of discomfort.

How to Recognise Kidney Stones in Children

It can be difficult to diagnose kidney stones based on symptoms alone. Because other conditions can mimic the same type of pain. A doctor may recommend:

Blood tests to check kidney function
Urinalysis to detect blood or infection
Imaging tests such as ultrasound, X-ray, or CT scan to confirm the presence of stones

If a child experiences severe abdominal or side pain, they should be evaluated promptly in a clinic or emergency department.

Treatment for Kidney Stones in Children

The treatment of kidney stones in children varies. However, the best treatment depends on the size, location, and symptoms of the stone. Most importantly, the treatment depends on the overall health of children. Here are the treatment options:

Observation and Medical Expulsive Therapy

A kidney stone is easily managed if it is small and not causing significant blockage and infection. Observation is a process to monitor if kidney stones pass easily or not. And expulsive therapy is a treatment that includes medicines to increase the chance of passing the stones naturally. Doctors often monitor the stone’s progress through imaging studies every few months.

Children may receive:

Pain and nausea medication for comfort
Tamsulosin is a medication that helps relax the ureter and allows stones to pass more easily.

Parents are usually advised to strain the urine each time the child urinates. This helps catch the stone once it passes, allowing for laboratory analysis to determine its type and cause. Even though passing a stone can be very painful, most small stones will eventually pass into the bladder and out through the urethra on their own.

Important Note

Pain may sometimes decrease even if the stone has not passed. It can be dangerous. Prolonged blockage can damage the kidney. That's why follow-up with a doctor is essential. Seek a doctor immediately if pain or vomiting cannot be controlled. Even if the child develops a fever. A fever during stone passage may indicate a serious infection that requires urgent treatment.

Surgical Options for Removing Kidney Stones

Surgery is left as the only option if the stone does not pass through the urine. It becomes important when a stone is too large to pass. Also, it causes persistent blockage or leads to infection. The choice of surgery procedure depends on the stone’s size, location, and complexity.

Extracorporeal Shock Wave Lithotripsy (ESWL)

Extracorporeal shock wave lithotripsy is a non-invasive method. In this method, shock waves are used to break the stone into tiny fragments from outside the body. These fragments then pass naturally through the urine.

No incisions are made

Performed as a day procedure

Children usually return to normal activities within a few days

Ureteroscopy

This is the most common surgical approach for children. A tiny camera (scope) is inserted through the urethra and bladder into the ureter to locate and remove or break the stone into smaller pieces. A small temporary stent may be placed to keep the ureter open and ensure urine drains properly during recovery.

Percutaneous Nephrolithotomy (PCNL)

Used for larger or complex stones, percutaneous nephrolithotomy is a less invasive method. This method involves a small incision in the back to access the kidney directly. The surgeon uses a camera and special tools to break and remove the stones. For this treatment, children typically stay in the hospital overnight. Children recover within days after this treatment.

After the Stone Is Removed: Preventing Future Stones

Passing or removing a kidney stone is just the beginning. Children who develop one stone are at high risk of forming another later in life. Identifying the underlying cause is critical to prevention.

Doctors usually recommend a metabolic workup. It is a series of medical tests that includes:

Blood tests to assess calcium and other minerals
24-hour urine collection to check for abnormal levels of stone-forming substances

Based on the test result, here are some preventative measures that you need to follow:

Increase intake of water daily.
Reduce processed food, salt and consumption of sodium.
Limiting foods high in iron (like nuts, chocolate, and spinach)
Encouraging a balanced diet rich in fruits and vegetables
Prescribing specific medications if needed

General prevention advice from the internet can be too broad. The key is a personalised plan guided by medical evaluation to prevent kidney stones in kids.

When to See a Doctor

If you feel and see any kind of stone symptoms, go to a doctor. Seek medical help right away if your child has:

Persistent or severe pain
Vomiting that prevents fluid intake
Blood in the urine
Difficulty urinating
Fever or chills (possible infection)

Early evaluation and management are crucial to prevent complications. Early diagnosis in children helps in preventing the formation of kidney stones.

Key Takeaway

Kidney stones in children are becoming more common. But they are highly treatable with proper medical care. Early diagnosis and adequate hydration are crucial for preventing future stones in children. Ongoing follow-up is vital for preventing future stones and ensuring healthy kidney function.

FAQs

Can kidney stones pass on their own in children?
Yes, kidney stones pass on their own in children. Small stones often pass naturally within a few weeks. However, they easily pass with hydration and medications that help relax the ureter.
What causes kidney stones in kids?
There are various reasons for stone formation in kids. However, the most common reasons are dehydration, dietary factors and genetic predisposition. Certain metabolic conditions can also increase the risk.
How can I help my child prevent kidney stones?
You can prevent the formation of kidney stones in your children. For this purpose, encourage your child to drink plenty of water. Also, reduce salty and processed foods from their daily diet and ensure regular medical check-ups if your child has had stones before.
Are kidney stones dangerous?
Kidney stones are painful, but they are not life-threatening. But untreated infection or obstruction can lead to serious damage to the kidney. That’s why medical follow-up is crucial.
What food causes kidney stones in children? Food that contains sodium causes kidney stones in children. Pure salt and canned and packaged food increase the risk of kidney stones in children.