Kidney stones are increasingly affecting younger individuals, including 15-year-olds. Though less common than in adults, their incidence in adolescents has risen over the past two decades, with a notable increase among teenage girls. This trend highlights the need to understand this condition in younger populations, as it can lead to severe pain and potential health complications if not properly addressed.
Understanding Causes in Adolescents
Kidney stone formation in adolescents is a complex process influenced by multiple factors. Stones develop when minerals and other substances in urine become highly concentrated and crystallize into hard deposits. The most common types in U.S. children are calcium oxalate and calcium phosphate, though uric acid, cystine, and struvite stones also occur.
Dietary habits play a significant role, with high sodium intake being a notable contributor. Excess sodium can lead to increased calcium in the urine, promoting stone formation. Similarly, diets high in processed foods, fast food, sodas, and those with high fructose corn syrup are associated with greater risk. Inadequate hydration is another factor, as insufficient fluid intake results in concentrated urine, making crystal formation easier.
Genetic predispositions also contribute; a family history of kidney stones increases a teenager’s likelihood. Specific inherited conditions, such as hyperoxaluria, cystinuria, and certain metabolic disorders affecting urinary flow or mineral levels, can elevate risk. Underlying medical conditions like diabetes, obesity, urinary tract abnormalities, and certain medications (e.g., topiramate, furosemide, some antibiotics) can also increase susceptibility. Prolonged immobility, such as being in a cast after surgery, can contribute by causing calcium release from bones into the urinary tract.
Identifying Symptoms
Recognizing kidney stone symptoms in adolescents is important for timely intervention. The most common sign is sudden, severe pain, often described as excruciating. This pain typically begins in the back or side, just below the ribs, and can radiate to the lower abdomen and groin as the stone moves through the urinary tract. The pain may come and go in waves.
Other symptoms include nausea and vomiting. Blood in the urine, known as hematuria, is another common indicator and can make the urine appear pink, red, or brown. Adolescents may also experience a frequent or urgent need to urinate, or pain and burning during urination. These symptoms arise from the stone’s movement or if it causes a blockage in the urinary tract, potentially leading to kidney swelling.
Treatment and Prevention Strategies
Managing kidney stones in adolescents involves immediate symptom treatment and long-term prevention strategies. For smaller stones, the goal is to facilitate passage while managing discomfort. This often includes encouraging fluid intake to help flush the stone. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can manage pain, and stronger medications may be prescribed for severe discomfort. Adolescents with severe pain or persistent vomiting may require hospitalization for intravenous fluids and pain medication.
If stones are too large to pass naturally or cause complications, medical interventions are used. Shockwave lithotripsy is a non-invasive procedure that uses sound waves to break the stone into smaller pieces. Ureteroscopy involves inserting a thin scope through the urinary tract to locate and either remove the stone or break it with a laser. Studies indicate that shockwave lithotripsy may offer faster recovery and less pain compared to ureteroscopy for pediatric patients. For very large stones, percutaneous nephrolithotomy may be necessary, where a small incision is made in the back to access and remove the stone; after removal or passage, the stone may be analyzed to determine its composition, which helps guide future prevention efforts.
Preventing kidney stones in adolescents focuses on lifestyle modifications, especially adequate hydration. Drinking plenty of water keeps urine diluted; a general guideline is 64 ounces daily, aiming for pale yellow or clear urine. Dietary adjustments are also important: limit sodium, avoid excessive protein, and reduce processed foods, fast food, and sugary beverages.
Increasing fruits and vegetables, especially citrus, is helpful as they contain citrate, which prevents crystal clumping. Maintaining a healthy weight and ensuring adequate calcium intake (without over-supplementing) are also important, as restricting calcium can sometimes increase stone risk. Adolescents who have had a kidney stone face a higher likelihood of recurrence, with approximately 50% within three years.
When to Consult a Doctor
Prompt medical attention is needed if a teenager exhibits kidney stone symptoms. Seek evaluation for persistent or severe pain in the back, side, or abdomen that does not improve. The presence of visible blood in the urine, known as hematuria, also warrants a medical visit.
Other signs needing immediate medical consultation include fever and chills accompanying pain, which could signal an infection. An inability to urinate or passing only very small amounts of urine, along with nausea or vomiting that prevents oral fluid intake, are also concerning symptoms. Recurrent episodes of symptoms, even if less severe, should also prompt a discussion with a healthcare provider to investigate underlying causes and develop a prevention plan.