Paediatric Stone disease

Urinary stones typically occur in adults, but the prevalence of paediatric stones appears to be increasing in children. Number of factors contribute to paediatric stone disease but it is commonly associated with metabolic abnormality in the body. An anatomical problem like an abnormality in the urinary tract obstructs the kidney or ureter and rise the paediatric kidney stone disease in children.

Urolithiasis, kidney stones, renal stones, and renal calculi are some of the other names of paediatric kidney stones. When the crystallization of solutes concentrates above the saturation point it changes into a hard and solid substance. There are several materials that form stone:

• Increased Calcium oxalate due to calcium combining with oxalate in the urine. An inadequate amount of calcium and water forms calcium oxalate in both children and adults.
• Increased Uric acid forms stone in the kidney
• Increased content of oxidized sulfur-containing amino acid
• Increased Magnesium ammonium phosphate in blood and urine

Infants from 0-2 years are becoming more commonplace for kidney stones.

When a higher amount of ingredients of stones are stored in the kidney without enough water, it creates stone-forming material in the urine. Childhood obesity, climate change, hot climate, unhealthy diets, and metabolic malfunctioning also contributed to this problem. When the child has a birth defect in the urinary tract, the paediatric stone possibility also increases.

Typical symptoms of bladder stones include:

• Severe lower abdominal and back pain on either side
• Difficulty in urinating
• Blood in urine
• Irritation, nausea, and vomiting
• Foul smells and cloudy urine
• Fever

Stones may be found in the kidney, bladder, and urinary tract. Stones in the ureter cause obstruction in the kidney and resulting in severe pain.

• Diagnosis starts with checking of medical history and physical examination
• Blood and urine test
• Imaging tests like CT scan is done to know the exact size and shape of the kidney stones
• A Kidney-ureter-bladder x-ray is done to know the size of the stone and its position
• Renal bladder ultrasound to know about the obstruction

The best treatment procedure depends upon the size, location, and nature of the stone. Treatment of kidney stones is the same in children and adults. Though, less invasive treatment is suggested for child’s stone diseases.

• Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive procedure, where a high-energy shock wave breaks the stones into fragments that are passed through urine. This is the best treatment choice for treating kidney stones in children. This is done by X-rays or ultrasound to locate the exact position of stones.
• Endoscopy is done to treat urinary tract stones. An endoscope is inserted through the ureter to perform surgery for the removal of urinary stones.
• Percutaneous nephrolithotomy is rarely used for complicated stones. Small instruments are passed through the skin and remove the kidney and ureteral stones with laser.

Children who develop stones at an early age are more at a higher risk of developing in the future. Drinking enough fluids, eating fruits and vegetables, fewer salts in food, exercises can reduce the risk of stone formation.