Kidney Stones (Pediatric)
What are kidney stones?
Kidney stones (calculi) are hardened mineral deposits that form in the kidneys when there is a high level of calcium, oxalate, or uric acid in the urine; a lack of citrate in the urine; or insufficient water in the kidneys to dissolve waste products.
What are the symptoms of kidney stones?
If your child has a kidney stone, symptoms may include:
- pain in the abdomen, flank (side), back, or groin
- blood in the urine
- frequent urination
Our team diagnoses kidney stones by taking a thorough medical history and doing a physical examination, laboratory evaluation, and imaging tests.
How are kidney stones treated?
Treatment depends on the size and type of stone, the underlying cause, the presence of urinary infection, and whether your child repeatedly develops stones. Stones that are 4 mm and smaller (less than 1/4 inch in diameter) pass without treatment 90 percent of the time; those 5 to 7 mm pass half the time; and those larger than 7 mm rarely pass without therapy.
Your child may need treatment if a kidney stone does not move through the ureter within 15 days, fever develops, or pain doesn't improve. Urologists use several procedures to break up, remove, or bypass kidney stones:
Extracorporeal shock wave lithotripsy
Sound waves break the stone into tiny particles that can be passed. This outpatient procedure is effective for stones in the kidney or upper ureter but not for patients with large stones or other medical conditions.
A fiberoptic telescope (ureteroscope) is inserted through the urethra and passed through the bladder to remove or break up stones with a laser. Ureteroscopy is an outpatient procedure.
Percutaneous nephrolithotomy (PCNL)
Our surgeon threads catheters through guide wires that pass through the skin and into the kidney. Surgical instruments are manipulated through the catheters to break up and remove large complex kidney stones. This procedure usually requires hospitalization, and most patients resume normal activity within two weeks.
Three small (3 to 5 mm) incisions are made, and the patient's abdomen is distended with carbon dioxide. Our surgeon extracts the stone through an incision in the ureter or kidney, which is then repaired. Most patients require overnight hospitalization.
Can the formation of new kidney stones be prevented?
Our team provides instruction on how to prevent future stones. Your child may need to increase fluid intake and make dietary changes, such as limiting meat, salt, and foods high in oxalate (green leafy vegetables, chocolate, and nuts). Medication may be prescribed in some cases, and treatment for underlying conditions that cause kidney stones may be necessary.