Factors that place a child at increased risk for developing kidney stones are:

• Family history of stones
• Decreased water intake or long periods of dehydration
• Repeated urinary tract infections
• Diet high in sodium and/or protein
• Obesity
• Decreased activity level
• Defects in the urinary tract
• Use of certain medications, such as chemotherapy drugs and anti-convulsants

Certain conditions cause elevated levels of stone-forming substances such as calcium, oxalate and cystine in the urine, increasing the likelihood of stone formation. These conditions include:

• Hypercalciuria
• Hyperoxaluria
• Primary Hyperoxaluria
• Cystinuria

Read more detailed information about these associated conditions.

Associated risk factors that increase the likelihood of stone formation include:

• Urinary tract infections: Urea is a waste product found in urine. Some types of infecting bacteria break urea down into substances that form stones.
• Defects in the urinary tract: These may create areas of slow urine flow where stone-forming substances have a chance to settle and form stones.
• Cystic fibrosis: Faulty absorption in the intestine and other factors lead to too much oxalate in the urine, predisposing a child to form stones.
• Inflammatory bowel disease: Increased intestinal absorption of oxalate leads to high amounts of oxalate in the urine, with an increased chance of stone formation.
• Seizures: Certain anti-seizure medications or an anti-seizure (ketogenic) diet increase the risk of stone formation.
• Children with neurogenic bladder (as seen in Spina Bifida) have a higher likelihood of delayed urination and for repeated urinary tract infections from incomplete bladder emptying.
• Duchenne muscular dystrophy: Children with this disorder are often treated with steroids, which increase calcium in the urine. When these children decrease mobility— start using a wheelchair—the risk of developing stones increases. Also, because it is harder to go to the bathroom, they tend to decrease fluid intake, which also increases stone formation.
• Decreased activity: Any child who is unable to move around—for instance, one confined to a wheelchair—is at increased risk of developing kidney stones.

A child may have a sudden, severe pain in the side of the body. The pain can spread out to the belly, groin or genitals. It may be so painful that the child is unable to find a comfortable position. Other symptoms include:

• Pain with urination
• Blood in the urine
• Frequent / persistent urinary tract infection
• Urinary urgency and/or frequency
• Nausea / vomiting
• Fever

Kidney stones are often diagnosed in the Emergency Department, when children come in with severe belly or side pain.

For children and young adults with recurring stone formation, it is likely that they will need multiple radiology exams during their lifetime to identify the location and size of stone(s). Cincinnati Children’s takes this seriously and makes every effort to minimize how much radiation your child receives.

We are part of an Image Gently campaign, created to promote methods that reduce radiation dose during pediatric medical imaging exams.

Learn more about the diagnosis of urinary (kidney) stones in children and young adults.

The treatment for kidney stones depends on the size, what they are made of, and whether they are causing symptoms or blocking the urinary tract.

Small stones will likely pass on their own without treatment, but will often require pain control and encouragement for your child to drink extra fluids to help the stone pass. Larger stones or ones that block urine flow may require surgery.

The three main forms of treatment for kidney stones are:

• Medications
• Surgical procedures
• Prevention through diet and exercise education

Learn more about treatment methods for children and young adults with urinary (kidney) tract stones.

The most important way to prevent kidney stones from forming is drinking a lot of fluids. This keeps the urine dilute, and stones are less likely to form.

Your doctor will also order a 24-hour urine collection that a special lab, Litholink, will evaluate to see what kind of stones your body is making. From that evaluation the doctor can decide what medications or treatments you may need to help kidney stones from forming.