Kidney stones in kids on the rise

CHICAGO – Doctors are puzzling over what seems to be an increase in the number of children with kidney stones, a condition some blame on kids’ love of cheeseburgers, fries and other salty foods.

Kidney stones are usually an adult malady, one that is notorious for causing excruciating pain. But while the number of affected children isn’t huge, kids with kidney stones have been turning up in rising numbers at hospitals around the country.

Johns Hopkins Children Center in Baltimore, a referral center for children with stones, used to treat one or two youngsters a year 15 or so years ago. Now it gets calls about new cases every week, said kidney specialist Dr. Alicia Neu.

In a 2007 study in the Journal of Urology, doctors at North Shore-Long Island Jewish Medical Center reported a nearly fivefold increase in children brought in with kidney stones between 1994 and 2005. In 2005, 61 youngsters were treated there for stones.

Dr. David Hatch at Loyola University Medical Center in Maywood, Ill., near Chicago, also has seen an increase. His youngest patient was a cranky 8-month-old girl whose mother found a pea-size kidney stone in her diaper.

Kids’ stones have been the talk of recent pediatric kidney specialists’ conferences, said Dr. Uri Alon, director of the bone and mineral disorders clinic at Children’s Mercy Hospital in Kansas City.

So far, the only evidence is anecdotal. But Alon is involved in research trying to determine if the increase is real and not just the result of greater awareness and better ways of detecting stones. Alon also is studying whether improved nutrition can prevent kids’ kidney stones.

Eating too much salt can result in excess calcium in the urine. In children, most stones are calcium-based, and Alon said their eating habits, plus drinking too little water, puts them at risk. Plenty of water is generally recommended to help prevent kidney stones.

The main problem associated with kidney stones is extreme pain. It is caused by stones blocking urine flow, which, if untreated, could lead to kidney damage.

The preferred treatment is observation – giving kids pain medicine but nothing else to see if the stones will pass on their own.

When that doesn’t happen, the patient is anesthetized and doctors may thread a slender scope through the urinary tract to break up and remove the stone. Other treatment may involve noninvasive shock-wave therapy that uses sound waves to break up the stone, or minimally invasive surgery.