Kidney Health in Kids

I didn’t know youngsters struggled with kidney stones until one of my students had to miss school because the pain from one was so great. As it turns out, the incidence of kidney stones is rising sharply among children (an 11 fold increase).

There are a number of reasons for why both adults and children develop this painful condition and most of it has to diet, which means it is also preventable. Factors that put us at risk is not drinking enough fluid and ingesting too much of what dehydrates us, so avoid drinking too much caffeine, eating too much salt (should take in no more than 3000 mg. per day) and protein, and eating too much oxalate found in chocolate, peanuts, spinach, tea and black pepper.

The biggest cause of kidney stones is not drinking enough decaffeinated liquid. Doctors recommend that we drink enough to make more than a half a gallon of urine. “The Institute of Medicine reported that U.S. women who appeared to be adequately hydrated consumed the equivalent of about 91 ounces of fluids each day, and men about 125 ounces -- far more than the 64 ounces in eight glasses of water --but stated that beverages other than water and the fluid in solid foods also counted toward the total. Even a slice of white bread is more than 30% water.

Doctors believe that if we wait until we’re thirsty to drink that we are already dehydrated. It is imperative to drink water constantly throughout the day especially if the weather is hot or physical activity is high, which, of course is the reason that children are prone, that and the fact that too many children live on a steady diet of colas, energy drinks and sweets. How do these bad choices impact our kidneys? Well let’s look at what the kidneys do as described by American Urological Association Foundation.

“What do the kidneys do?

Your kidneys are bean-shaped organs, each about the size of your fist. They are located near the middle of your back, just below the rib cage, one on each side of the spine. The kidneys are sophisticated trash collectors. Every day, your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The wastes and extra water become urine, which flows to your bladder through tubes called ureters. Your bladder stores urine until you go to the bathroom.

The wastes in your blood come from the normal breakdown of active muscle and from the food you eat. Your body uses the food for energy and self-repair. After your body has taken what it needs from the food, wastes are sent to the blood. If your kidneys did not remove these wastes, they would build up in the blood and damage your body.

In addition to removing wastes, your kidneys help control blood pressure. They also help make red blood cells and keep your bones strong.

What is a kidney stone?

A kidney stone is a solid piece of material that forms in a kidney out of substances in the urine.

A stone may stay in the kidney or break loose and travel down the urinary tract. A small stone may pass all the way out of the body without causing too much pain.

A larger stone may get stuck in a ureter, the bladder, or the urethra. A problem stone can block the flow of urine and cause great pain.
Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not pass. It may even get larger. You should call a doctor if you have any of the following signs:

• extreme pain in your back or side that will not go away
• blood in your urine
• fever and chills
• vomiting
• urine that smells bad or looks cloudy
• a burning feeling when you urinate

Are all kidney stones alike?

No. Doctors have found four major types of kidney stones.
• The most common type of stone contains calcium. Calcium is a normal part of a healthy diet.
• Though calcium is a normal part of a healthy diet, that which is not used by the bones and muscles goes to the kidneys. In most people, the kidneys flush out the extra calcium with the rest of the urine. People who have calcium stones keep the calcium in their kidneys.
• The calcium that stays behind joins with other waste products to form a stone. The most common combination is called calcium oxalate.
• A struvite stone may form after an infection in the urinary system. These stones contain the mineral magnesium and the waste product ammonia.
• A uric acid stone may form when the urine contains too much acid. If you tend to form uric acid stones, you may need to cut back on the amount of meat you eat.
• Cystine stones are rare. Cystine is one of the building blocks that make up muscles, nerves, and other parts of the body. Cystine can build up in the urine to form a stone. The disease that causes cystine stones runs in families.

What can my doctor do about a problem stone?

If you have a stone that will not pass by itself, your doctor may need to take steps to get rid of it. In the past, the only way to remove a problem stone was through surgery.

Now, doctors have new ways to remove problem stones. The following sections describe a few of these methods.

Shock Waves

Your doctor can use a machine to send shock waves directly to the kidney stone. The shock waves break a large stone into small stones that will pass through your urinary system with your urine. The full name for this method is extracorporeal shock wave lithotripsy. Doctors often call it ESWL for short. Lithotripsy is a Greek word that means stone crushing.

Two types of shock wave machines exist. With one machine, you sit in a tub of water. With most newer machines, you lie on a table. A health technician will use ultrasound or x-ray images to direct the sound waves to the stone.

Tunnel Surgery

In tunnel surgery, the doctor makes a small cut into the patient's back and makes a narrow tunnel through the skin to the stone inside the kidney. With a special instrument that goes through the tunnel, the doctor can find the stone and remove it. The technical name for this method is percutaneous nephrolithotomy.

Ureteroscope

A ureteroscope looks like a long wire. The doctor inserts it into the patient's urethra, passes it up through the bladder, and directs it to the ureter where the stone is located. The ureteroscope has a camera that allows the doctor to see the stone. A cage is used to catch the stone and pull it out, or the doctor may destroy it with a device inserted through the ureteroscope.
Ask your doctor which method is right for you.

How will my doctor find out what kind of stone I have?

The best way for your doctor to find out what kind of stone you have is to test the stone itself. If you know that you are passing a stone, try to catch it in a strainer.

Your doctor may ask for a urine sample or take blood to find out what caused your stone. You may need to collect your urine for a 24-hour period. These tests will help your doctor find ways for you to avoid stones in the future.

Why do I need to know the kind of stone?

The therapy your doctor gives you depends on the type of stone you have. For example, a medicine that helps prevent calcium stones will not work if you have a struvite stone. The diet changes that help prevent uric acid stones may not work to prevent calcium stones. Therefore, careful analysis of the stone will help guide your treatment.

Points to Remember

•Most stones will pass out of the body without a doctor's help.
•See your doctor if you have severe pain in your back or side that will not go away.
•See your doctor if you have blood in your urine-urine will appear pink.
•When you pass a stone, try to catch it in a strainer to show your doctor.
•Drink lots of water to prevent more kidney stones from forming.
•Talk with your doctor about other ways to avoid more stones.

For More Information, contact:

American Urological Association Foundation
1000 Corporate Boulevard, Suite 410
Linthicum, MD 21090
Phone: 1-866-RING-AUA (746-4282)
Email: patienteducation@auafoundation.org
Internet: www.auafoundation.org
www.UrologyHealth.org