Kidney Stones in Children

Kidney stones in children grow from minerals, acids and salts that build up in their kidneys. This buildup can turn into hard deposits. Some are as small as a grain of sand. Others have been known to grow as large as a golf ball. Sometimes, kidney stones are so small, they may not cause any pain as your child pees them out. Other times, they can be quite painful.

And they can affect anyone at any age — including your child. Not drinking enough water each day (dehydration) is often a main culprit behind kidney stones in children. Dehydrated kids make less pee than usual. And their bodies aren’t always able to naturally flush out the mineral buildup. Having conditions like diabetes, cystic fibrosis or inflammatory bowel disease (IBD) may also increase your child’s chance of kidney stones.

When your child has kidney stones, they may complain of a bad tummy ache or that it hurts to pee. As a parent, you’ll want to look for pain in their side, back, belly or groin that comes and goes. Your child may also have nausea and throw up. Their pee may have blood in it or look cloudy. All are signs to see a healthcare provider ASAP.

What to expect at your child’s first visit

When you come to your child’s appointment, their provider will take time to get to know your child and understand what’s been going on. This means they’ll ask a lot of questions about your child’s health, symptoms and pain, like:

• When did your child first start mentioning symptoms?
• What kind of symptoms does your child have?
• Have these symptoms stayed the same or gotten worse?
• How are these symptoms affecting your child’s life?
• What other medical conditions, if any, does your child have?

During this visit, your child’s provider will do a physical exam. And they’ll order an ultrasound to see inside your child’s kidneys and urinary tract. They may also test your child’s urine to check for blood, microscopic crystals or infections. And blood tests can help our team see how well your child’s kidneys work and if they have any infections or other problems.

Meet Our Kidney Stones in Children Team

When your child comes to Cleveland Clinic Children’s for kidney stone treatment, they’ll have a care team of experienced pediatric providers working together to plan and manage their care, including:

• Pediatric urologists
• Pediatric nephrologists
• Pediatric radiologists
• Pediatric nurse practitioners
• Pediatric ultrasound technicians
• Child life specialists

When you hear your child has kidney stones, the first thing that may come to mind is surgery. But often, these stones are so small that surgery isn’t always necessary. Your child’s treatment plan depends on the size of their stones and how the condition affects them. About 80% of kidney stones can pass on their own.

Passing small kidney stones

If your child has small stones, we may first have them drink a lot of fluids. Generally, stones smaller than 5 millimeters (slightly smaller than a quarter of an inch) can usually pass without further treatment. They move in their urine from their kidneys down their pee tubes (ureters) into their bladder and then out of their body.

We may also prescribe medications to help with pain and to help to relax their ureter. This can make it easier for them to pass the stones in their pee.

Sometimes, passing kidney stones might only take a day or two. Other times, it may take a couple of weeks. How can you tell if they’ve passed the stones? We’ll send a strainer home so you can sift out the stones. You’ll put them in a bag and bring them to our team so we can analyze them in a lab. If your child hasn’t passed the stones within a couple of weeks or develops a fever, they may need to have surgery or another treatment.

Getting rid of large or stubborn kidney stones

Kidney stones larger than 5 millimeters often don’t move as easily through their urinary system. Sometimes, even smaller stones won’t be able to pass in your child’s pee. These stones can keep moving around painfully in your child’s kidneys. Or they may block part of their urinary tract. When this happens, your child may need treatments to break up or remove the stones, like:

• Shockwave lithotripsy
• Holmium laser lithotripsy
• Cystolithopaxy
• Ureteroscopy
• Percutaneous nephrolithotomy
• Laparoscopy surgery

Your child’s care team will walk you through their recommended treatment plan, so you know what to expect every step of the way.

Life After Treatment for Kidney Stones in Children

Once your child has kidney stones, they have a higher chance of getting them again (recurrence). You can help prevent this from happening to your child by:

• Making sure they drink plenty of water
• Limiting salty foods like pizza, potato chips and other junk food
• Avoiding high-sugar, high-calorie drinks
• Encouraging physical activity
• Your provider may also order a 24-hour urine collection to better understand why your child gets stones — and the best targeted way to prevent them from continuing to form

Taking the Next Step

Knowing your child is in pain can be a terrible feeling. The good news? Kidney stones in children are treatable. Our skilled pediatric nephrology and urology experts will help your child pass the stones or remove them. And they’ll share ways to help keep your child’s kidney stones from coming back.