Patient education: Kidney stones in children (The Basics)

What are kidney stones? — Kidney stones are just what they sound like: small stones that form in the kidneys and urinary tract. The urinary tract is a group of organs that includes the ureter, bladder, and urethra (figure 1).

Kidney stones are made of salts and minerals that are normally in urine. Sometimes, these salts and minerals clump together and form small stones. Children can get kidney stones, just as adults can.

Kidney stones are usually carried out of the body when a child urinates. But sometimes, a kidney stone gets stuck on the way out. If this happens, the child can have pain, blood in the urine, and other symptoms.

What are the symptoms of kidney stones? — The symptoms can include:

●Pain in the belly or back

●Blood in the urine, which can make urine pink or red

●Pain when the child urinates

●The need to urinate in a hurry

●Nausea or vomiting

●Being irritable and crying when urinating (in small children)

Some children with kidney stones do not have any symptoms. In these children, doctors often find the kidney stones by accident. This can happen if a child has an imaging test, such as an X-ray or ultrasound, for another reason.

Should my child see a doctor or nurse? — Yes. If your child has the symptoms listed above, take them to the doctor or nurse as soon as possible. Kidney stones can block urine flow and cause infections.

Will my child need tests? — Yes. The doctor or nurse will do an exam and order tests on a sample of your child's urine. They will also order an imaging test, such as a CT scan, ultrasound, or X-ray. Imaging tests create pictures of the inside of the body. They can show if a kidney stone is causing the symptoms. If your child has a stone, imaging tests can also show its size and where it is located.

How are kidney stones treated? — Treatment is different for each child. The right treatment depends on:

●The size, type, and location of the stone

●How much pain the child has

●If the child is vomiting, and how much

●If the child can drink large amounts of fluids

●If the kidney stone is blocking the flow of urine

If the stone is small and causes only mild symptoms, the child might be able to stay home and wait for it to pass in your child's urine on its own. If your child is going to try this, their doctor will tell you what they need to do. This usually includes:

●Drinking lots of fluids

●Taking pain medicines, such as ibuprofen (sample brand names: Advil, Motrin) or medicines that make it easier to pass the stone

●Urinating through a strainer so you can catch the stone when it comes out

Your child might need treatment in the hospital if:

●The stone is blocking urine flow

●The child has severe pain or is vomiting

●The child cannot drink large amounts of fluid

Hospital treatment can include:

●Pain medicine, either as pills, or into a vein through an "IV" if the child is vomiting too much to keep pills down. An IV is a thin tube that goes into a vein.

●Fluids given into a vein through an IV. This increases urine flow to help pass the stone.

●Treatment to remove the stone, or break it into smaller pieces so it can pass more easily. Doctors can do this with:

•A machine that uses sound waves to break up stones into smaller pieces, called "shock wave lithotripsy"

•A special kind of surgery that is done through tiny holes in the skin – During this surgery, the doctor puts tiny tools through the holes and into the child's urinary tract or kidney. Then, they remove the stone.

•A thin tube that goes into the body where the urine comes out – The tube has special tools on the end that doctors can use to break up stones or take them out.

What problems do I need to watch for? — If your child is trying to pass a kidney stone at home, call their doctor or nurse for advice if:

●They do not urinate for more than 8 hours.

●They have a fever of 100.4°F (38°C) or higher, or they have chills.

●Their urine is cloudy, smells bad, or has more blood in it than before.

●The pain from their kidney stone gets very bad and taking pain medicine doesn't help.

●They are throwing up and can't keep liquids down.

●Their pain does not go away after 1 to 2 weeks.

Will my child have another kidney stone? — Maybe. If your child gets a kidney stone, they have a higher risk of getting another one later. To help keep this from happening, make sure your child drinks plenty of water.

Your doctor or nurse might do tests to find out what caused the first stone. Depending on the results, you might need to change what your child eats. If so, the doctor or nurse can tell you which foods your child should not eat. They might also prescribe new medicines to keep your child from having another kidney stone.

More on this topic

Patient education: Kidney stones in adults (The Basics)
Patient education: Blood in the urine (hematuria) in adults (The Basics)
Patient education: Blood in the urine (hematuria) in children (The Basics)

Patient education: Kidney stones in children (Beyond the Basics)
Patient education: Kidney stones in adults (Beyond the Basics)