A kidney stone in a child is a rarer phenomenon compared to a similar formation in the urinary system of an adult. However, children can also suffer from kidney stones, also called urolithiasis or nephrolithiasis.
And the stone itself, like in adults, is a formation consisting of certain s alts and organic compounds contained in the urine. This pathology is usually caused by metabolic disorders, but they can be of a very different nature.
Reasons for education
It is believed that if there are kidney stones in children, the reasons are congenital anomalies in the structure of the kidneys and urinary tract.
In fact, studies have shown that these anomalies are the cause of urolithiasis in only 48% of cases. At the same time, factors such as:
- genetic predisposition to such a disease;
- prematurity factor;
- the impact of various harmful substances on the mother's body during pregnancy and even before it (this is not necessarily smoking, maybe workin chemical industries);
- pregnancy with complications, severe toxicosis or preeclampsia.
It is interesting that breastfeeding or, conversely, feeding with artificial mixtures does not affect the process of stone formation. When a child grows up, irregular meals still play a negative role, as well as the abuse of fast food and convenience foods.
Also at a later age, enzymatic disorders, hyperthyroidism, and kidney disease can play a negative role. It should be noted that urolithiasis is often combined with chronic pyelonephritis, but it is not always the root cause of its development.
Kidney stones in a child at 2 years old are found quite rarely. Usually, the first signs of urolithiasis are fixed later, unless its development is really associated with congenital anomalies of the internal organs or with a genetic predisposition.
There is a theory that in childhood, the primary cause of stone formation may be a urinary tract infection, which takes a chronic form. In about 62-65% of cases, kidney stones are found in a child of 3 years or a little older.
Symptoms of kidney stones in children
The main symptom of urolithiasis is pain. In many ways, the signs of kidney stones in children coincide with the clinical picture of this disease in adults. However, there is an important difference. If adults are more likely to experience renal colic, then children feel aching pains that are diffuse in nature, and this maysignificantly complicate the diagnosis of urolithiasis in a child. In addition, often the baby cannot even correctly show where exactly it hurts.
In adults, in most cases, pain is felt mainly in the lower back, while in children it can be given to the stomach. Therefore, parents often suspect food poisoning, appendicitis or an attack of gastritis in such a situation. But if the calculus is low, then the child can give pain to the leg. Boys may experience glans pain.
If there are kidney stones, the symptoms in a young child will also be characteristic. Although the baby may not yet show that he is in pain, the presence of pain will be noticeable by crying and general anxiety.
Additional features
Symptoms such as:
- signs of general intoxication (weakness, lethargy, loss of appetite);
- fever, sometimes fever;
- dysuria, that is, delay or lack of urination;
- hematuria - the appearance of traces of blood in the urine, this symptom indicates that the stone prevents the outflow of urine or even managed to damage the mucous membrane of the ureters;
- nausea and vomiting.
This clinical picture is due to the fact that at an early age, urolithiasis is most often accompanied by an infection of the genitourinary system. Passage of small stones resolves with less severe symptoms and is often found incidentally.
Asymptomatic
In some casesthe disease is almost asymptomatic. At least outwardly, it does not manifest itself in any way if the stone is small and does not interfere with the outflow of urine.
It can only be detected during an ultrasound of the kidneys. This is precisely what urolithiasis in children is dangerous for, since parents do not know anything about it (the child does not experience pain, there are no other external manifestations), and after some time kidney failure develops. To prevent this from happening, you need to visit a urologist regularly.
Interestingly, calcium stones are the most common in children. But their other types - urate stones and struvite - are detected much less frequently.
Diagnosis of kidney stones in children
Due to the fact that the manifestations of urolithiasis in children can be very similar to signs of pyelonephritis, acute appendicitis, cystitis, kidney injury and other pathologies, additional diagnostics are required. This means that laboratory tests and an ultrasound of the kidneys are performed. X-ray diagnostic methods are used. Of these, excretory urography is considered the most informative study. An overview image of the entire urinary system is taken.
If the discharge of the calculus does occur, it is recommended to carry out the chemical composition of the stone (spectral analysis, optical crystallography is done).
Conservative treatments for urolithiasis
If kidney stones have been found in children, treatment can be asconservative and surgical. Conservative therapy includes several areas at once, primarily the relief of a painful attack, as well as the removal of inflammation and the dissolution of stones (which is possible only for relatively small calculi).
During an attack, it is recommended to first stop the pain, for this, non-steroidal anti-inflammatory drugs are used, which include, for example, Nurofen. These drugs not only relieve pain, but also prevent the development of a second attack. Such drugs should be used with caution in patients with kidney failure, as they may aggravate the disease. But at the same time, they do not affect he althy kidneys.
As for the dissolution of stones, the choice of drug depends on their chemical composition. For example, if these are calcium stones, then Lidaza, methylene blue, and Furosemide as a diuretic are prescribed. If we are talking about the dissolution of oxalate stone, then fitin and vitamin B6 are prescribed. With a mixed type of stones, an extract of madder dye is prescribed in tablets, Fitolizin (it is produced in tubes), Nieron, Cystenal, and other drugs.
Anti-inflammatory, analgesic and diuretic effect is possessed by such combined herbal remedies as Cyston, Cystenal and Canephron N.
If all the listed conservative methods did not give the desired effect, then kidney stones are crushed in children or other surgical procedures are used.methods in accordance with WHO recommendations.
Surgical treatment for kidney stones
Surgical intervention is allowed only if there are certain indications, which include:
- constant pain that is felt despite the fact that the child is taking painkillers;
- serious impairment of kidney function;
- stone growth in size;
- development of secondary infection;
- hematuria, that is, the appearance of blood in the urine, which indicates damage to the walls of the organs of the urinary system.
Both the age of the child and the "age" of the kidney stones matter. If they were identified 2-3 years ago, and during this time they could not be dissolved, then they will have to be de alt with by more radical methods.
Various surgical techniques are used.
External lithotripsy
In recent years, remote lithotripsy, that is, the removal of a stone by crushing, has become widespread. It is not recommended for all cases, but only for those when the diameter of the calculus does not exceed 2.0 cm, and this formation itself has a relatively low density.
In developed countries, urological tables are used for this, in which modern lithotripters are already built in.
Influence on stones in this case is carried out using methods of shock wave therapy, when waves of this type are directed at the stone, affecting it with a certain frequency. The power of this wave, its other characteristics, the number of repeated sessions - all this is determined by the attending physician.
External lithotripsy is contraindicated in hemorrhagic diathesis, in the presence of an untreated urinary tract infection, and also in cases where there are serious deformities of the musculoskeletal system, or when a small patient is obese.
Contact lithotripsy
If it is a large calculus, then contact lithotripsy methods are used. One of the most common is percutaneous nephrolithotripsy.
It is used when the diameter of the calculus exceeds 2 centimeters, or when the diagnosis shows the presence of multiple kidney stones. Sometimes it is carried out in cases where the remote technique did not give the desired result.
But this type of operation is also contraindicated in cases of urinary system infection, as well as in the presence of tumors of any origin.
Open surgeries are now extremely rare as they involve the most traumatic intervention.
Conclusion
Nephrolithiasis is a serious disease that requires qualified medical care. Self-treatment, especially traditional medicine methods, as many advise, not only will not get rid of the problem, but can aggravate the situation.
