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Nephrolithiasis

What is Nephrolithiasis? 

Nephrolithiasis, commonly known as kidney stones or renal calculi, typically occurs in adults, but it can happen in children as well. Some doctors say there is anecdotal evidence that more children are having this condition, probably because of consuming too much salt. Kidney stones can occur even in babies. A renal stone is a crystal. Kidney stones form when high amounts of certain substances accumulate in the kidneys forming a stone. Certain stones are caused by other diseases but many are related to diet and nutrition.

Types of kidney stones: 

  • Calcium stones are the most common type, usually caused by high intake of certain substances, such as salt.
  • Cystine stones can form in people who have cystinuria, an inherited disorder, marked by increased formation of stones in the bladder, kidney and ureter.
  • Struvite stones most often occur in women who have urinary tract infections. 
  • Urica acid stones can occur with gout or after chemotherapy. 

Symptoms: 

Intense pain in the lower back and/or in the sides
Frequent, painful urination

Nausea, vomiting
Blood in the urine and/or cloudy urine
Urinary tract infections, secondary to kidney stones, accompanied by fever

Diagnosis  

  • A test to measure uric acid levels 
  • Urinalysis 
  • Abdominal CT scan 
  • Abdominal/kidney MRI 
  • Abdominal X-rays 
  • Kidney ultrasound 

Once the stone is found, it should be analyzed to determine what type of stone it is. 

Treatment 

Most stones pass down the urinary tract on their own and are eventually expelled. Pain relievers, often potent ones, are needed to manage the pain. Increased fluid intake will help the stone to pass. Antibiotics may be given if the stone causes a urinary tract infection.  Stones that don’t pass need to be removed surgically. Dietary changes and drinking plenty of fluids are recommended to prevent recurrence. 

When to call for help 

If your child shows any signs suggestive of a kidney stone, call your pediatrician.

At Hopkins Children’s, kidney stones are treated at the Pediatric Stone Clinic, which is jointly run by the divisions of Urology and Nephrology.
 

External Links:

National Library of Medicine (National Institutes of Health)