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When most people think of kidney stones, they think of adults. However, in recent years, there has been an increase in the incidence of kidney stones in children. Kidney stones most commonly occur in children between ages 10 – 19.
Why is this happening? Along with rising obesity rates in America, several studies have shown that morbidly obese children excrete more oxalate in their urine, predisposing them to forming kidney stones.
In addition to obesity, our children rarely drink the amount of water they should. We live in a society where water has to be flavored or colored for our children to drink it. Coupled with climate changes due to cyclical weather trends and global warming, children are often relatively dehydrated. This contributes to stone formation.
Our diets also contribute. Studies show an increased consumption of dark-colored soft drinks, sweetened drinks and sodium intake by children is linked to stone formation. In children ages 6 – 11, increased sodium content in processed and restaurant foods has led to a significant rise in consumption.
Most children with kidney stones have vague abdominal pain that often prompts a trip to the emergency room and advanced imaging studies, such as CT scans, to make a diagnosis. Other symptoms include burning upon urination, intense scrotal/labial pain, passage of visible blood in the urine, intense back pain or severe nausea and vomiting.
Once a stone is formed in a child, it can be difficult to pass due to the small size of the urinary tract. There are a couple options to treat this problem.
If the stone is unable to pass, minimally invasive surgical techniques to remove it, in collaboration with a pediatric anesthesiologist, are available. One method is extracorporeal shock wave lithotripsy (ESWL). With ESWL, the stone is pulverized into sand using shock waves, making it much easier to pass.
If ESWL is not appropriate, endoscopic approaches may be useful. With endoscopy, a small telescope is passed through the urinary tract to extract the stone.
While pediatric stone disease is, unfortunately, on the rise and there appear to be many possible contributing factors, it can be treated effectively and safely in a “kid-friendly” manner.
And remember, the solution to pollution is dilution. Have your children drink plenty of water!
Anand V. Palagiri, MD, a Mercy Clinic pediatric urologist and director of pediatric urology with Mercy Children’s Hospital St. Louis.