When it comes to kids, stomachaches and pains go with the territory, but sometimes it can be hard to tell if they’re serious or not. Since kidney stones in kids have significantly increased over the last two decades, it’s a good idea to know what to look for, especially since kidney stones can technically affect anyone, at any age.
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How kidney stones form
Kidney stones develop when the minerals normally found in your urine build up to high levels, resulting in hard deposits that vary in size, shape and texture. If they’re tiny, they can pass through your urinary tract without any difficulty, but the bigger they become, the more likely it is that they’ll get stuck and/or cause pain.
Dehydration, inactivity & sodium play a role
One of the biggest reasons for the jump in numbers of kids and teens coming in with kidney stones, other than medical conditions, is simply not drinking enough water, says pediatric urologist Jeffrey Donohoe, MD.
When a kidney stone is suspected, the child’s urine is collected for 24 hours. It is then sent to a lab to test the mineral content and levels, note the amount of urine produced and to check for metabolic disorders such as diabetes.
It’s rare for me to find a metabolic disorder, but almost every patient I’ve seen has a low volume of urine. If you’re not making enough urine, you’re probably not taking in enough fluid.
Since fluids help flush minerals through your system, not staying hydrated is associated with developing kidney stones. “Lots of kids think they drink enough water, but especially if they’re active, they need to drink more,” says Dr. Donohoe.
So how much water is enough? “For kids over 12, I recommend from 2 to 2½ liters of water a day,” Dr. Donohoe says. “For a younger child, 1 to 1½ liters.” (Note: 1 liter is equal to slightly over 4 cups.)
“A sedentary lifestyle and a high sodium intake in the diet are also associated with the development of kidney stones,” notes Dr. Donohoe. Fast food and highly processed foods, staples in the average American diet, are key offenders.
What symptoms of kidney stones should parents know about?
Kidney stone symptoms to watch for include:
- Pain in the side, back, abdomen, or groin that can come and go and may cause nausea and/or vomiting.
- Pain while urinating.
- Bad-smelling urine.
- Needing to urinate a lot more often.
- Blood in the urine, making it look brown, pink or red.
- Cloudy urine.
- Difficulty urinating.
What if a kidney stone is suspected?
Along with 24-hour urine collection, children with suspected kidney stones have an ultrasound to look for stones and obstructions. To minimize radiation exposure to kids, a computerized tomography (CT) scan or other imaging tests are best reserved for later, if needed.
And what happens if my child does indeed have a kidney stone?
The good news is that the majority of kidney stones are fairly small, so most kids don’t need surgery. First, they’re told to drink plenty of fluids, including lemonade that’s made with real lemons, “not store-bought lemonade because most of that’s sugar,” says Dr. Donohoe. The citric acid in the lemons increases the citrate content of urine, a nutrient that makes it more difficult for kidney stones to form.
Children may also be prescribed mild pain relievers and medication that dilates their ureters, the tubes connecting the kidney to the bladder, helping the stone pass through more easily. A strainer is sent home so that any stones in the urine can be sifted out, put in a zip top bag and brought in to be sent to a lab to have the content analyzed.
Surgery is a last resort. If the stone doesn’t pass within a few days, patients usually have about a month before surgery is deemed necessary. However, all bets are off on the wait-and-see approach if a patient develops a fever during that time — this indicates a possible and potentially life-threatening kidney infection that needs immediate surgery.
How to prevent more kidney stones in the future
Because kids with kidney stones have a 50% lifetime risk of having a recurrence, “we hit home that they need to drink more water, drink the lemonade and try to avoid sodium,” Dr. Donohoe says. “That means potato chips, pretzels, pizza, and all that kind of food.”
Parents should help their kids stay away from high-sugar, high-calorie drinks, and make sure their child increases his or her fluid intake in hot weather or with exertion and encourage physical activity.