Kidney Stones in Children

Expert Care for Children with Kidney Stones

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Kidney stones are not common in children, but when they occur, your child will need a comprehensive evaluation and effective treatment. Our pediatric urologists work closely with kidney doctors (nephrologists) and endocrinologists to find the cause of your child’s stones and start treatment to relieve discomfort as quickly as possible. This may include dietary recommendations or medications to prevent new kidney stones from forming.

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Symptoms of Kidney Stones in Children

Discomfort from kidney stones can appear in many ways. Your child may need to see a pediatric urologist if they experience:

Pain in their abdomen, flank, or groin
Difficult or painful urination
Blood in their urine
Unexplained nausea or vomiting
Fever
Recurrent urinary tract infections (UTIs)

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Diagnosing Kidney Stones in Children

Kidney stones can run in families. Understanding your family’s medical history can help us diagnose your child. We may perform one or more of the following tests to determine the best treatment for your child.

Blood and Urine Tests

These tests check your child’s blood and urine to find out why a stone developed, if it is affecting kidney function, and how to prevent kidney stones in the future. If performed in our clinic, we may get results from these tests within three days. Your doctor may ask you to collect your child’s urine at home over 24 hours using a special kit that can be mailed to the laboratory. In this case, it typically takes about a month to receive the results.

Ultrasound

Ultrasounds (also known as sonograms) use sound waves to create images that help us look for kidney stones in your child’s kidneys, ureters, and bladder. It’s a painless, outpatient exam performed by a doctor or technician. It does not expose your child to radiation.

Plain X-Rays and CT Scans

Your doctor may need more information than an ultrasound can provide. A plain X-ray or CT scan provides more precise information about the stone(s).

Collecting Stones at Home

If your child passes a stone between doctor visits, try to collect it, save it in a jar or plastic bag at room temperature, and bring it to your next visit. The stone can be analyzed to learn its chemical makeup. This information can be used to determine why your child formed a stone and how to prevent them in the future.

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Treating Kidney Stones in Children

Many children can pass kidney stones without medical help. Drinking more water and taking medicine (when advised) is often enough to pass kidney stones within a few days. If a urinary tract infection (UTI) is present, the stones are large, or the stones are causing extreme discomfort or nausea, more treatment may be recommended to remove the stones or reduce their size so they can be passed.

Extracorporeal Shock-Wave Lithotripsy

This noninvasive, outpatient procedure uses shock waves to break kidney stones into tiny pieces so they can more easily pass out of your child’s body in their urine. An instrument is placed on your child’s abdomen or back to direct shock waves to the precise location of the stones. Sedation or full anesthesia may be needed because the shock waves cause temporary discomfort. Your child will go home the day of the procedure and may feel some discomfort. It is normal to see small amounts of blood in their urine in the first days after the procedure.

Ureteroscopy

For this outpatient surgical procedure, your child will be asleep under full general anesthesia. A small, thin tube is inserted in your child’s urinary tract from the bladder, up into the ureter or kidney, to locate and remove the stone. We use a special tiny telescope called a ureteroscope designed for a child’s smaller body, decreasing the risk of injury. For small stones, we may grab them in a very small basket to remove it. For larger stones, we may use a laser to break it into smaller pieces for safe removal.

If your child’s anatomy does not allow the ureteroscope to reach the stone or if there is an active UTI, your urologist may place a small plastic tube, called a stent, from the kidney to the bladder. This allows your child’s ureter to open up, helps them pass urine, and aids in clearing the infection. If this is done, your child will have a follow-up procedure to remove the stone. The stent may need to be removed later during a quick trip to the operating room, but sometimes we leave a tiny string on the stent so that it can be removed without anesthesia.

Percutaneous Nephrolithotomy

Large kidney stones may be removed through a minimally invasive procedure, which is performed with your child under full anesthesia. A small incision is made in your child’s back, and a flexible tube is inserted to access to the stone. Then a telescope is used to see the stones, which are broken into smaller pieces with a laser or sound waves in order to remove it. Your child may stay in the hospital for one night following this procedure.

Preventing Future Kidney Stones

If your child has had a kidney stone, there’s an increased chance that they could develop stones again. Analysis of the passed stone(s) along with urine and blood tests help us pinpoint the cause. Your child’s care will be managed by a pediatric nephrologist and dietitian. They may recommend your child drink more water and track their fluid consumption. They can also recommend medications or dietary changes to reduce the likelihood that kidney stones will return.

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Duke Children's Hospital & Health Center is proud to be nationally ranked in 9 pediatric specialties.

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A Team of Specialists
We work closely with pediatric experts throughout Duke and coordinate our efforts to make getting care more convenient for you. Whenever possible, your child will benefit from the expertise of multiple specialists in a single visit. This comprehensive care has earned us national recognition.

If Your Child Needs Surgery
You can feel confident in your child’s treatment at Duke Children’s, which is certified as a Level I Verified Children’s Surgery Center by the American College of Surgeons. This designation recognizes our commitment to providing the safest and highest-quality surgical care to our young patients.

This page was medically reviewed on 04/02/2024 by

John S. Wiener, MD | Pediatric Urologist