Little Rock, AR - 14-year-old Bradley Entrekin has a kidney stone - the size of two grains of sand.

He’s in so much pain, his parents rushed him to the emergency room.

“It’s amazing how something so little could cause so much pain,” says Bradley’s doctor, Kathleen Nelson.

“I don’t see how it does,” answers Bradley.

“Well, what happens is it causes a little spasm in the tube that leads from the kidney down into the bladder,” says Dr. Nelson. “And it’s really the spasm that’s causing you the pain,”

Across the country, the number of kids with kidney stones is growing dramatically.

“It had been a disorder that a pediatric nephrologist might see once or twice a year,” says Dr. Larry Greenbaum, who treats kids with kidney stones at Children’s Healthcare of Atlanta. “Now, it seems like we are seeing it once a month.”

One reason for the increase is a diet that’s full of salt.

“So if you eat a lot of salt, it causes more calcium to go in your urine. And when you have more calcium in your urine, you are more likely to form kidney stones.”

Doctors say there are several ways to prevent kidney stones.

First, of course, reduce salt in the diet.

And drink plenty of water.

“Do you usually drink?” Dr. Nelson asks Bradley.

“I try to,” he answers, “but it’s kind of hard at school cause they don’t let me carry a water bottle around.”

Still, Bradley will need to drink even more water than most kids.

“There’s no doubt that once you’ve had one stone, there’s a good chance that you’ll have a second stone,” says Dr. Greenbaum, “and maybe a third or a fourth stone.”

Foods that have been shown to help prevent kidney stones are fruits, vegetables, and anything with calcium.


Tips for Parents Kidney stones are much rarer in children than in adults. Experts at Johns Hopkins Medical Institutions say children get kidney stones about 1 percent as often as adults – it is estimated that adults have a one-in-10 lifetime chance of developing serious kidney stones. However, doctors are now seeing a steep rise in young patients.

Adults are more likely to pass their stones with only medical management for pain. Children are more likely to have their stones removed. According to pediatric urologist Dr. Steven G. Docimo, “Odds are that the stones will eventually cause trouble, growing to obstruct the kidney.”

Some stones can be treated with extra corporeal shock wave lithotipsy. But the more “resistant” kidney stones may have to be surgically removed.

Kidney stones have plagued mankind for thousands of years. Scientists have even found traces of kidney stones in mummies more than 7,000 years old. Today, more than 1 million cases are reported each year in the United States, mostly in adults.

Kidney stones sometimes occur when urine becomes too concentrated. This causes minerals and other substances in the urine to form crystals on the inner surface of the kidneys. Eventually, these crystals may combine to form a small, hard, stone-like mass. Sometimes this mass, or stone, breaks off and passes into the ureter (one of the two thin tubes that leads from the kidney to the bladder). If the stone blocks the ureter, pain occurs.

Not all kidney stones cause symptoms. According to the Mayo Clinic, it’s not unusual for stones to be discovered in the kidneys during X-rays for an unrelated problem. If the kidney stone becomes large or causes a blockage or an infection, your child may experience “intense, colicky pain” that fluctuates in intensity over a period of five to 15 minutes. The pain starts in the back or side just below the edge of the ribs. As the stone moves toward the bladder, the pain may radiate down toward the groin. If the stone stops moving, the pain may stop, too. Other symptoms may include the following:

- Bloody, cloudy or foul-smelling urine
- Nausea and vomiting
- Persistent urge to urinate
- Fever and chills if an infection is present

In children, kidney stones are frequently linked with what Dr. Docimo calls “an underlying anatomical abnormality,” such as spina bifida, a reconstructed urinary tract or augmented bladder. The Mayo Clinic also lists the following “risk factors” that may increase the chances of developing kidney stones:

- Family or personal history: If someone in your family has kidney stones, you’re more likely to develop these stones, too.
- Age, gender and race: Most people who develop kidney stones are between 20 and 40 years of age. Men are more likely to develop kidney stones than women are, although for unknown reasons the number of women with kidney stones is increasing.
- Certain diseases: Rare, inherited diseases, such as renal tubular acidosis and cystinuria, can increase the risk of kidney stones.
- Certain medications: Taking certain types of water pills (diuretics), some thyroid medications or calcium-based antacids (Tums, Alka-Seltzer, Rolaids) may increase your risk of forming kidney stones. On the other hand, thiazide diuretics may help lessen the chance of stone formation.
- A single kidney: Although most people have two kidneys, approximately one in every 1,500 babies is born with only one kidney. Many people live full healthy lives with a single kidney, but they do have an increased risk of kidney stones.
- Diet: A diet that’s high in protein (meat, chicken, fish, etc.) and low in fiber (fruits, vegetables and whole grains) may increase your risk of some types of kidney stones.
- A lack of fluids: If you don’t drink enough fluids, especially water, your urine is likely to have higher concentrations of substances that form stones.
- Limited activity: You’re more prone to develop kidney stones if you’re bedridden or very sedentary for a period of time. That’s because limited activity can cause your bones to release more calcium.

The best way to prevent kidney stones is to drink lots of water so the stones get washed out of the body before they become large.


References
Mayo Clinic
Children’s Healthcare of Atlanta
Johns Hopkins Medicine
Birmingham Children’s Hospital

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