Kids and Kidney Stones—Factors that are putting some kids at high risk

September 2013 View more

Asian boy with an abdominal painIt may not be something you’d expect to see, but more and more kids are visiting the emergency room because of kidney stones. Over the past decade, cases of kidney stones, once only associated with middle-aged adults, are showing up in kids at alarming rates. Genetics, diet, and lifestyle can all play a part in the development of kidney stones.

 Developing Kidney Stones

They form when highly concentrated amounts of calcium, magnesium, and phosphorous build up in the urine. A family history of stones, especially in a parent or sibling, greatly increases the chance of having stones. Most children have some variety of calcium stones. “One thing you should know is that one should not try to avoid stone formation by decreasing dietary calcium intake. We actually recommend maximizing vitamin D as well as dairy intake to prevent a net deficit of calcium, which can have a negative effect on bone health,” said Dr. Sara Jandeska, assistant professor of pediatric nephrology, Rush Children’s Hospital.

 Risk Factors

Doctors are seeing the increase in young adolescents between the ages of 10 and 16. Environmental dietary influences, such as high obesity rates and not enough calcium are often the culprits. In many cases, kidney stones are due to 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. “The solution to pollution is dilution. For all stone types, kidney doctors recommend patients significantly increase their water intake,” said Dr. Jandeska. Doctors tend to see more cases in the summer and fall when children are more physically active, sweating more, and are more prone to dehydration.

Genetics also play a significant role in developing kidney stones. In fact, 50 to 60 percent of children with kidney stones have a family history of the disease.

Too much sodium in the diet is another risk factor. “I suspect the reason there is an increase in stones can be due to our diet in general. As you probably know, we Americans tend to eat too much salt. Not to be too simplistic, but when we urinate an excess of sodium, it drags calcium with it into the urine, a significant ingredient for kidney stone formation,” said Dr. Jandeska.

 Signs and Symptoms

Young children with kidney stones usually can’t pinpoint where the pain is located. They simply complain that their tummy hurts. Some young children will have no pain at all. Stones are later discovered during the evaluation of a urinary tract infection.

Older children and teens tend to experience a sudden, sharp onset of pain in the back or side. The pain can be constant and severe, causing nausea and vomiting. This pain may move into the groin area as the stone passes down the urinary tract. This can cause blood to appear in the urine.

“Once stones are made, and can be found in the kidney, very often they can be very small, they either remain in the kidney or pass. Small stones can pass with transient symptoms that may appear as if the child is cranky for a day or so, even without obvious blood in the urine,” said Dr. Jandeska.

Children who develop a kidney stone have a good chance of developing another stone unless the risk factors are corrected. You can’t do much about genetics, but you can guide your child toward a healthy lifestyle which can help prevent kidney stone formation. Keep kids physically active and hydrated. Teach them to monitor sodium intake. Limit the amount of soda and soft drinks. Set a good example by providing them with healthy food choices at home. A diet modest in sodium, but rich in grains and calcium is the key.