To diagnose kidney stones in children, a health care professional will review the child’s medical history and perform a physical exam. Certain lab tests like a urinalysis (urine test) or 24-hour urine collection may be recommended. A urinalysis can find blood in the urine and minerals that form kidney stones. The 24-hour urine collection test measures how much urine a child produces, minerals that can form stones and the pH level of the urine.
Depending on your child’s situation, your health care professional may also order a blood test. This shows if there are high blood levels of certain minerals that can lead to kidney stones. Imaging tests such as ultrasound or an abdominal x-ray may also be ordered. These tests can help doctors find the location of your child’s kidney stone.
How a kidney stone is treated depends on the type of stone it is, its location and size. A small kidney stone may pass through the urinary tract without treatment. In this case, your child will need to urinate through a strainer for a few days to catch the kidney stone. After the stone is collected, your health care professional will send the stone to a lab to find out what type it is.
If the kidney stone needs to be removed by a health care provider, a urologist can remove it or break it into small pieces. Pediatric urologists are are surgeons who can diagnose, treat and care for your child’s urinary problems. This includes kidney stones.
There a few ways a urologist can break up kidney stones. Shock wave lithotripsy works by breaking the kidney stone into small pieces from outside the child’s body. The smaller pieces of the kidney stone then pass through the urinary tract. A urologist gives anesthesia during this outpatient procedure.
Cystoscopy and ureteroscopy can also be used. During cystoscopy, a health care professional uses a thin tube with a tiny lens at one end to look inside the urethra and bladder to find the stone. During ureteroscopy, a longer and thinner instrument is used to see the lining of the ureters and kidneys. In both procedures, the urologist inserts the scope through the urethra to see the rest of the urinary tract. Once the stone is found, it can be removed or broken into smaller pieces. The urologist performs these procedures in the hospital with anesthesia. A child typically goes home the same day.
With percutaneous nephrolithotomy, a thin viewing tool called a nephroscope is used to locate and remove the kidney stone. A urologist inserts the tool directly into the kidney through a small cut in the child’s back. For larger kidney stones, a laser may be used to break the kidney stones into smaller pieces. A urologist performs percutaneous nephrolithotomy in a hospital with anesthesia. Recovery from percutaneous nephrolithotomy usually takes several days in the hospital.
If your child has experienced kidney stones in the past, your health care team may make diet recommendations to prevent future stones. For example, they may suggest changing your child’s intake of sodium, animal protein, calcium or oxalate. Oxalate is a natural substance found in many foods such as spinach.
Eating plans like the Dietary Approaches to Stop Hypertension (DASH) diet can help reduce the risk of forming kidney stones in children and adults. DASH is a low-salt eating plan that encourages fruits, vegetables, whole grains, low-fat dairy products, fish, beans and nuts.
Helping your child maintain a healthy weight can also help prevent kidney stones. If your child is overweight, work with your pediatrician and/or a registered dietitian to develop an eating plan that works for your family. Lastly, it’s important your child drinks enough water. This is the most important lifestyle change a child or teenager can make to prevent kidney stones.
Please listen to Urology Care Podcast Episode No. 68, When Kids get Kidney Stones with Dr. Gregory Tasian to learn more: