Kidney Stones in the Pediatric Patient

This chapter discusses predisposing conditions, clinical evaluation, and surgical and medical management of kidney stone disease or nephrolithiasis in pediatric patients. Kidney stone disease results from urinary crystal aggregation in a protein matrix within the urinary tract. Predisposing factors for nephrolithiasis can be determined in the majority of children affected. Less than 50% of young children with nephrolithiasis will present with abdominal, flank, or pelvic pain as seen in older children, adolescents, and adults with urinary tract stones. The goals of the surgical management of patients with kidney stones are to remove existing stones and prevent stone recurrence, with preservation of kidney function. Nonspecific management of urolithiasis includes an increase in fluid intake to increase urinary volume, urinary dilution, and inducing stone particle motion through the urinary tract. Pediatric patients with stone disease should be referred to a subspecialist for appropriate diagnosis, treatment, and long-term nephrology follow-up.