Kidney stones in children: Potential causes and what to look for

Published: Aug. 24, 2018 at 4:13 PM EDT
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What used to be a disease of middle-aged white males is now soaring in adolescents, and it may require extensive surgery to treat.

Doctors are seeing an increase in kidney stones in teenagers that has doubled over the past 20 years. It’s a painful condition that recurs in many patients and can become a lifelong disease for some.

Below, we explore possible causes of the condition in children, and what parents should look out for.

“It’s a dramatic increase,” Dr. Gregory Tasian said. “I really describe it as an epidemic.”

Why the increase of kidney stones in young people? New research suggests certain antibiotic use may be the culprit.

“The question becomes, if antibiotics are prescribed unnecessarily, for example a viral illness, that’s where we need to focus our efforts,” Tasian said.

Case in point: Emma Gaal, who suffered her first kidney stone at just 6 years old.

“When they said kidney stones, it was crazy,” said P.J. Gaal, Emma’s mom. “Doesn’t seem like someone her age could get that.”

“It feels like someone’s stabbing you,” Emma described. “All day, every day, until you pass it.”

“What that means for that child who has a stone earlier in life is they have lifetime in which stones can recur,” Tasian said.

Emma underwent laser surgery and had a stent placed in one of her kidneys.

The classes of antibiotics that doctors are researching as possible culprits are the following:

Fluoroquinolones, sulfa drugs, cephalosporins, nitrofurantoin and broad-spectrum penicillin, like augmentin.

And there are symptoms of kidney stones people should watch for:

“In a younger patient, for example, [he or she] may just have belly pain, blood in the urine and nausea,” Tasian said.

Emma, who underwent laser surgery to evaporate her stones and had stents placed in her kidneys, is back in action in track and field and heads to college in the fall.

“I’m double-majoring in special education and elementary education K-4, and I’m really excited,” Emma said.

Kidney stones, which can last a lifetime when children get them at a young age, are associated with high blood pressure and decreased bone density. In addition to antibiotics, researchers are looking at environmental factors as possible associated causes.



REPORT: MB #4459

BACKGROUND: A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine and often severe pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi. The condition of having kidney stones is termed nephrolithiasis. Having stones at any location in the urinary tract is referred to as urolithiasis, and the term ureterolithiasis is used to refer to stones located in the ureters. Most urinary stones develop in people 20 to 49 years of age, and those who are prone to multiple attacks of kidney stones usually develop their first stones during the second or third decade of life. People who have already had more than one kidney stone are prone to developing further stones.


DIAGNOSING: Symptoms of kidney stones in children include sharp pains in the back, side, lower abdomen, or groin, pink, red, or brown blood in the urine, a constant need to urinate, pain while urinating, inability to urinate, cloudy or bad-smelling urine and irritability, especially in young children. A child should see a health care professional right away when any of these symptoms occur. These symptoms can be caused by a kidney stone or a more serious condition. The pain of a kidney stone may last for a short or long time or may come and go in waves. Along with pain, a child may have nausea and vomiting. Other symptoms include fever and chills.


NEW RESEARCH: Gregory Tasian, MD, MSc, MSCE, attending Urologist at CHOP explained another part of the study, “Our group has demonstrated that high daily temperatures are associated with an increased risk of kidney stone presentation within 10 days. We also found that moist heat metrics such as heat index and wet-bulb temperature predict kidney stone presentations better than dry-bulb temperatures. Finally, we are preparing a manuscript that reports that males have a substantially greater risk of stone presentation than females for a given temperatures. We have performed most of this work in South Carolina, which has a dataset that captures all inpatient admissions, ED visits, and surgeries in the state.”

(Source: Gregory Tasian, MD)