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There are many ways you can help children and their families get the care they need.
Knowing that your child is suffering from kidney stones can be extremely upsetting. But you can rest assured that you're in the right place. At Boston Children's Hospital, we're known for our science-driven approach—we're home to the most extensive research enterprise located in a pediatric hospital in the world, and we've partnered with a number of top biotech and health care organizations—but our physicians never forget that your child is a child, and not just another patient.
How are kidney stones treated?
The best treatment will depend on the size, location, number and composition of your child's stone(s). In many cases, stones can be passed spontaneously without any treatment — in fact, children can pass stones that are relatively large compared to those that adults can pass.
Your child's doctors may prescribe certain medications that have been shown to increase the chance of a stone passing spontaneously.
What if my child can't pass the stone himself?
Sometimes it is necessary to remove the stones if warranted by your child's condition and symptoms. It also makes sense sometimes to remove a growing stone even if it is causing no symptoms, rather than waiting until it is very large.
The choice of technique depends upon the location, size and type of stone, as well as your child's anatomy. Methods include, the following, which are further described below:
The most common and least invasive way of treating stones, ESWL uses a special machine called a “lithotripter” to send shock waves through the skin into your child's body.
The lithotripter focuses the shock waves at the precise point where the stone is located, in much the same way that a magnifying lens can focus sunlight to create intense heat. This causes the stone to break into small fragments. Many shock waves are applied slowly, often several thousand. This may take up to an hour. The pieces will then pass in the urine over the following days.
This technique uses a small scope passed up through the urethra into your child's bladder, and from there up into one or both ureters (the tubes that connect the kidney with the bladder) and kidneys.
Digital cameras attached to the scope allow doctors to see the stones and remove them with a variety of specially designed instruments.
PCNL is used to treat large kidney stones, and employs a needle that goes through the skin and into the kidney, under ultrasound or x-ray guidance.
An instrument is then passed into the kidney to allow direct examination, fragmentation and removal of the stone.
Open stone surgery
Years ago, almost all stones required open surgery for removal. With advances in technology, however, most stones can now be treated with a less invasive approach, but open stone surgery is still needed occasionally in children with unusual anatomy or other specific conditions.
How do I make sure my child doesn't get more stones?
Effective prevention depends largely upon why the stones are forming. A metabolic evaluation of your child is necessary, in consultation with a pediatric nephrologist, to identify risk factors for stone formation.
This evaluation includes:
After this metabolic evaluation is completed, your doctor will better understand what is causing the stones — and how best to prevent your child from developing more stones. Sometimes, medications are required to help prevent future kidney stones.
Here's a list of some basic things you can do to decrease your child's chances of developing kidney stones:
What kind of treatment plan will the doctor prescribe?
It varies based on the cause of the stones, but some common ingredients are listed below:
If your child has an inherited condition that leads to kidney stones, doctors will create an individualized plan of care based on the nature and symptoms of the disorder.
These conditions include cystinuria, primary hyperoxaluria, Dent disease and other conditions that may increase stone risk.
After a child has his first stone and we've completed our initial evaluation, we like to see her twice a year. We check to see how she's drinking, monitor her symptoms and do follow-up urine and blood tests. We also check for development of new stones by follow-up ultrasound.
Coping and support
We understand that you may have a lot of questions when your child is diagnosed with kidney stones. Will these stones go away on their own? What do we do next? We've tried to provide some answers to those questions in the following pages, but there are also a number of other resources to help you and your family through this time.
Patient education: From your first office visit through the entire diagnosis and treatment process, our nurses will be available to help answer any questions you may have. They will also reach out to you by phone, continuing the care and support you received while at Children's.
Parent to parent: Want to talk with someone whose child has been treated for kidney stones? We may be able to put you in touch with other families whose children have been treated at Children's.
Social work: Our clinical social workers have helped many other families in your situation. Your social worker can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial difficulties.
Visit our For Patients and Families site for all you need to know about:
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.”