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Although considered as a disorder usually noted in older age, kidney stones are now becoming a common finding in school-aged and older children. This has created concerns both for the medical fraternity and the parents.

Introduction

Kidney stones also known as renal calculi refer to the hard masses that develop within the kidneys or the bladder.  The kidney stones are usually formed from calcium which combines with other substances such as oxalate or phosphate.

The size of the kidney stones vary from small crystals that pass out with the urine to larger crystals that block the minor tubes within the kidneys giving rise to pain and infections. The kidney stones are more commonly observed in men above the age of 40 years. In case of women kidney stones appear usually after the age of 50 years.

Causes of Kidney Stones

The exact cause for the occurrence of kidney stones is not known. However, various factors such as heredity, disorders of the kidneys, abnormalities in the process of urine formation, certain general disorders such as gout, excess intake of vitamin D, urinary tract infections and administration of certain medications such as diuretics have all been associated with an increased incidence of kidney stones in case of adults. Diet also seems to have a role wherein increased consumption of foods rich in a substance known as oxalate can promote the formation of stones in the kidney. Increased salt consumption is associated with water dehydration that may promote the formation of kidney stones.

During the process of urine formation in the kidneys, excess amount of certain substances are released into the urine while other essential substances are absorbed back into the body. Water is one such substance. If the body is facing deficiency of water (as in states of dehydration) some amount of water is absorbed back into the body making the urine more acidic. In such environments certain substances such as calcium oxalate tend to collect and form crystals. Adequate levels of water are considered necessary for preventing the formation of such crystals.

Kidney Stones in Children

Although considered as a disorder usually noted in older age, kidney stones are now becoming a common finding in school-aged and older children. This has created concerns both for the medical fraternity and the parents.

Why the Incidence of Kidney Stones is increasing in Children?

The increase in the incidence of kidney stones has been attributed mainly to abnormal diet and increasing body weight in children. Heredity may also have a role wherein children whose parents had kidney stones are at an increased risk.

The children in today’s world are not involved in physical activities that keep their body fit. Lack of exercise, improper diet and numerous other factors have led to an increase in the number of children becoming obese at a young age with a substantial increase in the obesity related disorders. In case of non-obese children, the alterations in diet such as increased consumption of salt and decreased intake of water has been proposed as causative factors.

Adequate amount of daily water consumption is required for the formation of urine and dehydration can increase the concentration of urine leading to stone formation. As in case of adults certain underlying disorders that affect the normal functioning of the kidneys may also result in formation of kidney stones in a few cases.

Common Symptoms

Children with kidney stones present with a wide range of symptoms based on the size of the stones formed and the duration of the condition. Small stones may not be noticed and may pass through urine without resulting in any symptoms.

As the condition progresses, these stones tend to get larger and obstruct the small tubes within the kidney, the ureters (that carry the urine) and the bladder (which stores the urine before being released from the body). Once the obstruction occurs it leads to pain. The pain felt may range from dull to excruciating type. Pain is usually felt in the lower abdomen and back region. At times, pain may be severe when the child tries to pass urine or he may complain of burning sensation while passing urine. In case of associated infections, urine mixed with blood may be observed. Other symptoms such as vomiting sensation (nausea), vomiting or fever may also be observed.

Diagnosis

The diagnosis is usually based on a comprehensive review of the signs and symptoms observed. Radiographs of the abdominal region are usually considered for confirmation of the diagnosis. In certain cases other specialised diagnostic methods such as ultrasound, computed tomography (CT) scan or intravenous pyelogram (IVP) may be advised. If the stone that may have passed out with urine is available, it is analysed to identify the type of crystal and thereby determine the cause of its formation.

Treatment Options

The treatment of kidney stones in children is based on factors such as size, number and location of the stones, severity of the condition, and the presence of other associated symptoms. In most cases, children with kidney stones do not require any treatment as the stones tend to pass out spontaneously. Certain dietary modifications may be advised to enable this process. An increase in the water consumption and decrease in the intake of salt is generally considered beneficial.

In case of severe conditions, non surgical treatment options such as lithotripsy or use of medications to dissolve the stones may be advised. Additional medications such as antibiotics may be advised if the presence of infection is suspected. Periodic examination to monitor the progress of the condition may be advised in certain cases. This is especially true in cases where kidney stones are a hereditary condition.

Read More: Kidneys Are The Hardest Workers In Your Body

Preventive Measures

The importance of proper diet has a multitude of benefits among which prevention of various disorders is one major benefit. Restriction of salt use has been found to be beneficial in preventing the formation or recurrence of kidney stones both in adults and children.

Urine is one of the main pathways through which water and other fluids are lost. If the body is dehydrated, it tries to conserve water by reducing the amount of water being excreted as urine. This in turn leads to the solidification of crystals that would have normally been excreted if there was adequate amount of water. Adequate intake of water and other fluids is therefore helpful, especially in summer or after physical activities.

It has also been noted that the risk of kidney stones is higher in children consuming excess amount of sodas rich with sucrose and in teenagers who follow high-protein weight loss diets. These habits must be discontinued and a proper balanced diet, adequate consumption of water and avoidance of high-fat and high-salt rich foods must be followed.

The amount of water consumption by children that has been stated to be ideal is at least 2 litres in a day and the salt consumption through foods must be restricted to a maximum of 1 teaspoon a day.

Adequate precaution can prevent the formation of kidney stones and also decrease the rising incidence of kidney stones in children.
 

  • www.bio-medicine.org/medicine-news/Increasing-Trend-of-Kidney-Stones-Among-U-S-Kids-17009-1/
  • www.informationliberation.com/?id=26094
  • kidney.niddk.nih.gov/Kudiseases/pubs/stonesadults/
  • www.childrenshospital.org/views/june07/pediatric_kidney_stones_on_the_rise.html

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