Pediatric Kidney Stones Symptoms & Causes

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It is difficult to see your child suffering from kidney stones. It can also be frustrating if your child has had multiple kidney stones and you’re having trouble figuring out what’s causing them. Read on to learn more about kidney stones and stone disease — and what they mean for your child.

What do the kidneys do?

The kidneys are the body's filtering system. They help control water levels and eliminate excess minerals and waste products by producing urine.

What are kidney stones?

Kidney stones are solid deposits of minerals and salts that build up in the urine collecting areas within the kidneys. They may start as microscopic particles, but over time they grown large enough to see.

Why are kidney stones a problem?

They can get lodged in the urinary tract and obstruct the flow of urine. Although most stones won’t cause long-term damage to your child, passing kidney stones can be extremely painful. Obstruction of the kidney can be dangerous because it can lead to infection or injury to the kidney, so it is important to get the problem diagnosed early.

What is the long-term outlook for my child?

It depends on what is causing your child to develop the stones. Some children form a single stone and never have another stone again. Others have multiple episodes of stones. Children with underlying genetic, anatomic or biochemical causes for stone formation are more likely to form multiple stones, and it is important that these conditions be identified and treated.

Some underlying medical conditions that lead to stones are lifelong and must be managed as such.

How common are kidney stones? 

Stones are not common in children, but they're getting more so.

Some children who form urinary stones have an underlying abnormality of the urinary tract. These can include obstructions of the kidney and ureter (the tube that connects the kidney with the bladder) or diseases such as spina bifida.

However, most children with stones have normal urinary tract anatomy.

We believe that the increase in kidney stones may reflect lifestyle factors such as childhood obesity, diets with excess salt and not drinking enough water. There are also genetic factors that play a role and we are still learning about these. Several studies are going on at Boston Children's Hospital to understand what genes contribute to kidney stones in children.

At what age do children typically form stones?

Stones can form in children of any age, but we generally see school-aged children and older. We also see premature babies whose course in the NICU let to risk of stones or whose medications throw off the balance of minerals in their urine and lead to kidney stone formation. Rarely, these babies may have more severe inheritable reasons for kidney stones.

Are kidney stones more common in boys or girls?

Stones can form in both boys and girls. Although stones in adults are more common in men than in women, the difference is not nearly as great in children.

Do environmental conditions affect stone formation?

Yes. We see more cases in the summer and fall when children tend to be more active, sweat more and are more prone to dehydration.

The highest concentration of Americans with kidney stones come from what we refer to as the "Stone Belt" in the southeastern states. This is probably due to the warm weather in those states, which can cause chronic dehydration, but there are probably other environmental and genetic factors that cause some areas to see more stones than others.


What are the symptoms of kidney stones?

Symptoms may vary from none, in the case of “silent stones,” (stones that are still in the kidney and have not moved to the ureter) to severe pain due to urinary obstruction.

Here’s a list of the most common symptoms of stone disease:

  • pain in the abdomen, flank (side), back, or groin
  • blood in the urine
  • frequent urination
  • nausea and/or vomiting

Keep in mind that kidney stones affect different children in different ways. Young children in particular may present with vague symptoms that can make diagnosis challenging.

Any child with pain accompanied by blood in the urine — even if it’s just a little bit — should be evaluated by a doctor.


What causes kidney stones?

Kidney stones form when there is too much of the mineral ingredients of the stone and not enough water in the urine.

This can occur either because there is an abnormally high mineral content in the urine, or the urine is too concentrated because of dehydration.

Some rare stone diseases can result from inborn metabolic problems, which means that the child has a genetic condition that causes his body to make these stones. A family history of kidney stones predisposes other members of the family to have stones, although how these tendencies are passed from one generation to the next is not well understood.

Children who can’t move for long periods of time (in traction after surgery, for example) may also be susceptible to stones, because when bones are inactive, they’re unable to regenerate themselves properly, which results in calcium being flushed into the system.

Questions to ask your doctor

You and your family are key players in your child’s medical care. It’s important that you share your observations and ideas with your child’s health care provider and that you understand your provider’s recommendations.

If your child is suffering from kidney stones and you’ve set up an appointment, you probably already have some ideas and questions on your mind. But at the appointment, it can be easy to forget the questions you wanted to ask. It’s often helpful to jot them down ahead of time so that you can leave the appointment feeling like you have the information you need. You may want to suggest that your child write down what he wants to ask his health care provider, too.

Some of the questions you may want to ask include:

  • Can my child pass these stones on his own?
  • What are our treatment options?
  • What sort of dietary changes do we need to make?
  • What can we do to encourage our child to drink more water?
  • Where can we go for further information?

Keep in mind that your doctor will want to ask you some questions, too. These can include the following:

  • Is this your child’s first stone?
  • Is there a history of stone disease in the family?
  • How much water does your child drink each day?
  • What’s your child’s diet like?


Q: How are kidney stones diagnosed?

A: Our doctors can tell if your child has a kidney stone by looking at his urinary tract with ultrasound or a CT scan.

Ultrasound is our first choice of diagnostic because there’s no radiation exposure. If the ultrasound is inconclusive — or if your child’s doctor has any questions about it — we might do a CT scan. A CT scan can also be used to help your child’s doctor locate the exact position and size of the stone for surgical planning. Plain x-rays of the abdomen and pelvis are sometimes ordered.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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