Kidney Stones in Children

Kidney diseases are often associated with negligent lifestyles of adults, but the painful truth is that kidney stones spare no one – not even kids.  Kidney trouble also occurs among children long before they know that junk food is not good for their kidneys.

Kidney stones (renal calculi, nephrolithiasis or urolithiasis) are less common among children than adults.  The stones develop because minerals, calcified materials or crystallized salts accrete over time.  The resulting stone then attaches to kidney walls and grow in size over time, blocks the flow of urine, and causes irreversible kidney damage if symptoms are not recognized early and medical intervention not applied.

In adults, kidney stones often develop because of poor diet and insufficient fluid intake, or intake of medicines that encourage crystal formation.  In children, stone development may be caused by underlying issues that put them at greater risk (of forming stones).  Children who do not suffer from underlying causes, yet develop stones nonetheless, are rare; the causes are often unknown.

Like adults, calculi in children may be because of prior history with stones or similar disorders; insufficient water intake; low-carbohydrate but high-protein diet; inherited disorders; medicines; or congenital urinary tract defects.

Kidney stones develop because salts and crystals normally found in urine become highly concentrated, and settle down to anchor to kidney walls.  This often happens because there is not enough fluid washing up the kidneys from excess salts.  All types of kidney stones could be prevented simply by drinking enough water.  All else being equal, calculi that are washed off by adequate fluids can be passed through the urethra (the tube that carries urine from the bladder and out of the body), eliminating procedures that may otherwise be invasive.

So how can you tell if children may suffer from stone formation?  Kids are particularly difficult to evaluate because they may find it hard to accurately describe what they feel.  However, when they begin to show signs, you may need to talk to their doctors for accurate diagnosis:

  • Backache or pain in the abdominal area;
  • Hematuria (blood in the urine);
  • Nausea or vomiting;
  • Rushing to the bathroom to urinate.

Doctors may perform several tests, like CT scans, ultrasound, X-ray and urinalysis.  Once confirmed, kidney stone treatment could be applied at home, or in the hospital.

Treatment at home is usually advised when pain is manageable and can be remedied by over-the-counter ibuprofen.  Children will also have to be closely supervised to make sure they drink enough water, usually 2000 ml for children 10 and above; 1500 ml for 5-10; 1000 ml for children younger than 5; and 750 ml for infants.  The amount of urine is dependent on the amount of water intake, and we want kids to produce as much urine as possible so they can easily pass stones without surgery.

Although not acknowledged (yet) by the West as an established form of adjunctive therapy, coconut water could replace some of the plain water to break the monotony.  In Eastern medicine, coconut water has long been praised for its rehydration and kidney-cleansing power.  Numerous studies have been carried out about its potency, and the benefits far outweigh the risks (which are still unheard of to date).  In Asian indigenous medicine, coconut water has been known to clear up the urinary tract, breaking up even large stones so they can be passed through urine, instead of surgically removed.

Diet, too, is an important component of preventing recurrence (because children who once had stones are likelier to develop the same once they get older).  The food children should eat depends on the type of stone they have; hence, it is crucial that stones be screened for identification at the laboratory:

  • Calcium stones:  A low-sodium and high-potassium (fresh fruits and vegetables) diet is recommended, plus calcium-rich foods that come from natural sources (not supplements, as they tend to aggravate the condition);
  • Oxalate stones:  Avoid oxalate-rich foods like beet, cocoa, chocolate, citrus juices, dill, nuts, parsley, pepper, rhubarb, spinach, star fruit, strawberries, sweet potatoes, tea, turnip greens and wheat bran.  Also avoid vitamin C supplements;
  • Urate stones:  These stones resulted from excess uric acid, so the urine should be as alkaline as possible.  Kids should avoid eating purine-rich foods (purine metabolizes into uric acid):  kidneys, liver, sardines, gravies, anchovies, brains and sweetbreads.

Well-supervised treatment at home could save both parent and child a trip to the hospital, or into the operating room.