UK HealthCast: What you need to know about kidney stones in kids
UK HealthCast is a podcast series featuring interviews with UK HealthCare experts on a variety of health-related topics, from how to recognize stroke symptoms to what patients need to know about clinic trials – and more.
Recently, Aftab Chishti, MD, FASN, and Campbell Grant, MD, joined UK HealthCast to discuss kidney stones in kids and how the multidisciplinary team at the Kentucky Children’s Hospital Kidney Stone Clinic can help.
Dr. Chishti is director of clinical services at the UK Healthcare Division of Nephrology, Hypertension, and Renal Transplantation.
Dr. Grant is a pediatric urologist at Kentucky Children’s Hospital.
What exactly is a kidney stone?
Dr. Chishti: Kidney stones are basically some huge, large deposits of minerals and salts that are formed inside your urinary tract, anywhere from within the kidney, down to the bladder … They are also called renal calculi or nephrolithiasis, which is a Latin complex word, or urolithiasis.
What are the signs and symptoms that a child may be suffering from kidney stones?
Dr. Grant: Obviously, kids sometimes may have a harder time giving symptoms (than) adults, but usually the main reason that most children present is because of pain, from a kidney stone that is blocking the outflow of urine from the kidney. That pain usually starts in the back or the flank, but it can also be in the belly or even go down toward the pelvis and near the bladder. It's usually accompanied by nausea or vomiting. Some of our patients feel like they need to go to the bathroom all the time, depending on where the kidney stone is. Or sometimes, they'll say that it hurts to pee. I have seen patients, too, where sometimes the first symptom that causes them to present to us is blood in their urine.
If your child is having severe pain, you should take them to the emergency department. I feel like that's the easiest thing for most parents, and it's probably the best way to get them treatment in the acute period where they're having that pain. If your child's only symptom is blood in the urine, you can consider making an appointment with your primary care physician to get further workup for that.
If children have recurring stones, is that the sign of a bigger problem and greater reason for concern?
Dr. Chishti: Once you have confirmed that the kid has kidney stone, then certainly a lot can be done to prevent kidney stones.
What I have always been taught is a sentence that I have used for every patient of mine: Solution to pollution is dilution - which is poetic, but all it means is drink, drink, and drink. The best thing we can do to prevent kidney stone is to drink enough water. Adult and kids alike, we all don't drink enough water.
If it keeps happening again - you had one six months ago, then you have one today and a couple of months later - then there definitely is an underlying potential problem, which could be genetic.
There are people who have genetic predisposition for kidney stones, or it could very well be your diet because in this day and age, we eat more protein than we should. We eat less vegetables and fruits than we should.
Who’s on the Kentucky Children's Hospital Kidney Sone Clinic team and how is it beneficial to have this multidisciplinary approach to care?
Dr. Grant: Our team includes pediatric urology, which is myself, our two nephrologists, Dr. Chishti and Dr. Kiessling, a dietician. We have nurses and social workers as well. And the big benefits of the multidisciplinary approach are, it allows all of us to work together, to come up with a coordinated treatment plan that's individualized to every kid.
