Kidney stones

Research: Rise in kidney stones in kids

Confirming anecdotal reports of doctors, researchers at Boston Children's Hospital found a tripling of kidney stones in children at pediatric hospitals across the country in the last decade.

"If you look at the raw numbers, the upward trend goes through the roof," says Caleb P. Nelson, MD, MPH, co-director of the Children's Kidney Stone Center. "The increase is not so dramatic when you adjust for hospital volume, but it is still there." The proportion of kidney stones among all patients at children's hospitals increased about 10 percent a year, from about 18.4 per 100,000 patients in 1999 to 57.0 per 100,000 in 2008, showed a study (Journal of Urology, September).

Although on the upswing, kidney stones in children remain relatively uncommon, about half the rate of appendicitis, the researchers calculated. "We don't have a good handle on why it may be going up," says Dr. Nelson, who notices his patients tend to be healthy-weight teens who may not drink sufficient water or who may have a family history of kidney stones. Studies in adults have implicated obesity and dietary salt, both of which are on the rise in children.

More information: childrenshospital.org/stone

Children’s Hospital Boston is the world’s largest research program at a pediatric institution, and we’re known for pioneering new treatments. A large part of our success comes from our commitment to research—and to advancing the frontiers of what’s possible in transplants through our innovative approach.

While kidney stones are still relatively uncommon in children, the number of cases is growing. In response, Boston Children's Hospital has established the Pediatric Kidney Stone Center to care for children with kidney stones, those who've previously had them and those who are at risk for developing them.

At our innovative center, your child will see both a pediatric urologist and a pediatric nephrologist at the same appointment. This multidisciplinary approach allows for direct collaboration between the two specialists to optimize your child’s care and work together to develop a treatment plan — in real time.

Minimizing radiation exposure

As part of your child's medical care at Children's, he might need to undergo an imaging study or scan to diagnose or help treat his stone disease. You may have read about the potential risk derived from radiation from imaging tests. We take radiation exposure from diagnostic imaging very seriously and our professionals go to great lengths to ensure that these tests are performed with the lowest possible radiation exposure to patients and families.

We routinely follow three steps to reduce the risk to children and families:

1. Studies that involve radiation are only used when they are deemed the most appropriate test for a particular patient. Diagnostic examinations that do not involve ionizing radiation, like ultrasound, are substituted for examinations using ionizing radiation, when appropriate. In addition, steps are taken to reduce the need for multiple studies involving radiation.
2. When an x-ray or CT scan is performed, our techniques are designed to ensure that the radiation dose is reduced to the amount needed to provide a diagnostic quality examination.
3. The imaging equipment is properly calibrated and optimized for the special imaging needs of your child. This helps ensure the best possible result and greatest safety at the lowest necessary radiation level.

Physicians, technologists, medical physicists and radiation safety professionals all play a role in assuring the best diagnostic image quality while minimizing radiation exposure to your child.

The professionals that oversee the use of ionizing radiation at Children's are leading national and international efforts toward radiation dose reduction through programs such as the “Image Gently” campaign, which aims to keep the medical use of radiation as safe as possible for children. Learn more about these efforts.