Monday, April 6, 2009

Kidney Stones are on the rise in children

You may have seen in the news recently that more children are developing kidney stones. Generally thought of as an adult condition, the prevalence of kidney stones in children has increased considerably.

Kidney stones can cause a variety of symptoms similiar to conditions such as a urinary tract infection or appendicitis. Symptoms can include abdominal or back pain that waxes and wanes and changes in intensity; blood in the urine; nausea or vomiting and urgency to urinate.

Younger children may may be able to express their discomfort and sometimes may not experience pain.

We recommend that if you suspect your child may have a kidney stone to contact the office immediately so that your physician can make a determination. Kidney stones can cause blockage and kidney damage so it is important not to delay having your child examined.

Dr. Mark Brinkman writes from his own experience about his daughter developing a kidney stone:

Last fall my 11 year-old daughter started to complain of abdominal pain. She was sitting on the couch, looking very pale and holding her side. I thought it was either gas pain or an early stomach virus. I told her to lie down and rest and the pain soon went away. Then about 4 hours later the pain returned. Julie was doubled over and again very pale. I had never seen her in so much pain and was worried she may have appendicitis but her abdomen was not tender. Then I realized I had seen this type of colicky pain before, but only in adults with kidney stones. “Julie is too young for a kidney stone, isn’t she?” Julie’s pain went away for the rest of the night and the next morning a urine test and ultrasound confirmed she had a kidney stone.

A recent Associated Press article states “Doctors are puzzling over what seems to be an increase in the number of children with kidney stones, a condition some blame on kids' love of cheeseburgers, fries and other salty foods. Kidney stones are usually an adult malady, one that is notorious for causing excruciating pain - pain worse than childbirth. But while the number of affected children isn't huge, kids with kidney stones have been turning up in rising numbers at hospitals around the country.” The number of children seen with kidney stones has gone up almost 5 fold, from one a month to at least one a week. The main problem associated with kidney stones is extreme pain. It is caused by stones blocking urine flow, which, if untreated, could lead to kidney damage. The preferred treatment is hydration and observation, giving kids pain medicine but nothing else to see if the stones will pass on their own. Stones can be as small as a sugar granule or as large as a pearl. Most are less than 1/4 inch in diameter, which can usually pass on their own. If the stone does not pass, doctors may thread a slender scope through the urinary tract (under anesthesia) to break up and remove the stone. Other treatment may involve noninvasive shock-wave therapy that uses sound waves to break up the stone, or minimally invasive surgery.

Kidney stones can be a sign of underlying metabolic problems that result in too much calcium in the urine, but in most cases children have no underlying disorder and are otherwise healthy. Childhood obesity, diets high in processed foods and salt and dehydration are all factors contributing to the increase in stones. Children are consuming more salt through processed foods and beverages such as chips, sandwich meats, packaged meals, canned soups and sports drinks. In addition, scientific evidence suggests that sucrose, which is found in sodas, may increase the risk of kidney stones. Dr David Hatch, a pediatric urologist at Loyola University Medical Center, states “the best prevention is plenty of water, so that the minerals in urine stay dissolved. How much water depends on a child's size, but for an average-size 10-year-old it would be about four cups a day, on top of whatever else they are drinking. That is far more than most kids drink. What I like to tell kids is that they should drink enough water to keep their pee almost clear." For children who have had one kidney stone, doctors sometimes recommend fresh-squeezed lemonade or other citrus juice, which can help keep the urine from forming stones.

Fortunately, Julie was able to pass her stone after a lot of hydration. We now watch the salt in her diet and have her drink plenty of fluids each day and she has not had another stone (knock on wood).

No comments: