“I suspect my son has kidney stones?”

Kidney stones, though uncommon in children, can happen. Trouble urinating is not usually a sking of kidney stone. The pain of kidney stone is also generally severe. In any case if he has difficulty urinating he needs a medial evaluation.

You son needs to be evaluated by Ped.Urologist

He needs a renal ultrasound that you can get through your pediatrician or an urgent care.

Dr. Niko Lailas

He would need to be seen and be examined and get a urinalysis. If there is blood in urine or findings on physical exam, he may need a CT to diagnose the stone and make sure it is not blocking the ureter.

I am sorry to hear this, as passing kidney stones is considered extremely painful. You need to go to the nearest emergency room. They will do an ultrasound, possibly also an x-ray and/or a CT scan. The diagnosis of kidney stones requires imaging. Whether or not the stone can pass by itself depends on its size. In the emergency room, they can give certain medications that may help to pass the stone. Certainly, effective pain control should be considered. If your child has a fever or only one kidney or decreased kidney function, the child may have to be admitted. The urine should be strained so that the stone can be analyzed. In a small proportion of cases, the stone cannot pass spontaneously and procedures are required to help. There are several options depending on where the stone is and how big it is. Often, a pediatric urologist and a pediatric interventional radiologist may be involved. You will also likely get a referral to a pediatric nephrologist. The role of the nephrologist is to determine if anything in the urine composition can be modified to reduce the risk of more stones. Unfortunately, 50% of patients have another stone within a year. Kidney stones are a chronic disease with a risk of developing chronic kidney disease. We are noticing a dramatic increase of kidney stones in children and adolescents, especially adolescents. This disease used to be a disease of elderly men but much of the increase of the incidence of kidney stones in the pediatric realm is seen in adolescent girls. The incidence seems to be doubling every 5-10 years, depending on your region. We often don't find any genetic cause. We used to see calcium wasting as the most frequent reason, but now insufficient urinary citrate has become the most frequent reason, together with a poor diet that is high in salt, animal protein, and very low in vegetables. That diet leads to a high acid load and low urinary pH. The high salt intake leads to calcium wasting, and the lack of citrate leads to calcium in the urine that can precipitate (make crystals) with other salts. We often treat with potassium citrate supplements or with lemon juice which is a natural source of citrate. We ask the patients to drink lots of water to dilute the urine, and we sometimes give them medication. With good management, new stones can be avoided in most patients. But for now, please seek immediate medical attention.

Guido Filler, MD, PhD, FRCPC