Kidney Stone Center
About us
The Kidney Stone Center at Children’s Hospital Boston is focused on the treatment and prevention of kidney stones in the pediatric population.
In our clinic, children are seen by a pediatric urologist and a pediatric nephrologist for a physical examination and discussion of their health. This discussion includes a detailed review of the child’s diet and fluid intake.
During this time, several tests may be also be performed, such as:
- urine analysis to assess for factors that contribute to stone formation, such as increased levels of calcium in the urine.
- blood tests that look for other risk factors, such as rare inherited disorders that can lead to kidney stones.
- chemical analysis (if the stone has passed or has been removed) to identify the type of stone. This can provide important clues about why it formed and how to prevent it from reoccurring.
Ultrasound is our first imaging choice since there’s no risk radiation exposure. However, if the ultrasound is inconclusive, a computed tomography (CT) scan will be performed. A CT scan uses x-rays to create images for the child’s urinary tract.
Once these tests are completed, you and your child will be asked to return for a follow-up appointment. During the follow-up appointment, our team of doctors will meet with you to review the tests results and discuss a treatment plan.
Treatment
Treatment is determined based on the size, location, number and composition of the stone(s). Children have a better ability to pass stones as compared to adults. In many cases, their stones can pass spontaneously without any surgical treatment. When it does become necessary for the stones to be removed,we use noninvasive or minimally invasive surgical techniques such as extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy. Less often, we will do percutaneous nephrostomy, a more invasive procedure for stones that are too big to be treated ureterosocpically.
Long-term care
Once the evaluation and treatment of the stone is complete, we will typically see the child twice a year to assess fluid intake, monitor symptoms and do follow-up urine and blood tests. We check for the development of new stones by follow-up ultrasounds.
Prevention is also a critical part of treatment. Not infrequently, a metabolic abnormality can be identified and treated with medication and dietary changes. Every child is prescribed a long-term preventative treatment plan that involves a high fluid intake and a no added salt diet. With regular follow-up and adherence to the established plan, it is our goal to reduce or prevent stone reoccurrence.
Children's urologists and nephrologists have compiled this list of tips to help you decrease your child's chances of developing kidney stones and preventing their recurrence:
- Encourage your child to drink plenty of water, not only when they are thirsty, but through the day. Keeping hydrated is extremely important!
- Avoid salty foods like chips, French fries, processed meats, canned soups, prepackaged meals and high-fat items. To cut salt intake, leave the saltshaker off the kitchen table and do not add salt to food while cooking.
- Focus on providing a healthy diet high in fruits and vegetables, and be sure to include the recommended daily allowance of protein, calcium and vitamin D.
- Exercise, exercise, exercise! Although fit children can develop kidney stones, many experts believe obesity may be related to higher rates. Make sure your child keeps hydrated while exercising.
- If there is a family history of kidney stones, pay extra attention to diet, exercise and water consumption.
